â° INDEX
Basics_of_Radiology-Basics_of_MRI_and_Interventional_Radiology
Basics_of_Radiology-Basics_of_Radiology
Basics_of_Radiology-Previous_Year_Questions
Basics_of_Radiology-Radiation_Exposure__Hazards__Protection_Guidelines__and_Contrast_Media
CT_Scan-Previous_Year_Questions
Cardiovascular_Radiology-CVS_Radiology
Cardiovascular_Radiology-Previous_Year_Questions
Gastrointestinal_Radiology-GIT_Radiology
Gastrointestinal_Radiology-Previous_Year_Questions
Genitourinary_Radiology-Genitourinary_Radiology
Genitourinary_Radiology-Previous_Year_Questions
Head___Neck_Imaging-Head_and_Neck_Radiology
Head___Neck_Imaging-Previous_Year_Questions
Hepatobiliary_Radiology-Hepatobiliary_and_Pancreatic_Radiology
Hepatobiliary_Radiology-Previous_Year_Questions
Magnetic_Resonance_Imaging-Previous_Year_Questions
Musculoskeletal_Radiology-Musculoskeletal_Radiology
Musculoskeletal_Radiology-Previous_Year_Questions
Neuro_Radiology-Neuroradiology-I
Neuro_Radiology-Neuroradiology-II
Neuro_Radiology-Previous_Year_Questions
Nuclear_Medicine-Nuclear_Medicine_and_Radiotherapy
Nuclear_Medicine-Previous_Year_Questions
OBGy_Imaging-Obstetrics__Gynaecology__and_Breast_Imaging
OBGy_Imaging-Previous_Year_Questions
Radiotherapy-Previous_Year_Questions
Reproductive_Radiology-Previous_Year_Questions
Thoracic_Radiology-Previous_Year_Questions
Thoracic_Radiology-Respiratory_Radiology
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Which of the following best describes the fundamental principle of MRI?", "options": [{"label": "A", "text": "Evaluate changes in magnetic field strength around tissues", "correct": false}, {"label": "B", "text": "Alignment and relaxation of hydrogen nuclei", "correct": true}, {"label": "C", "text": "Detection of thermal radiation emitted by tissues.", "correct": false}, {"label": "D", "text": "Measurement of varying ionizing radiation absorption.", "correct": false}], "correct_answer": "B. Alignment and relaxation of hydrogen nuclei", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GtpUCR2tlebHX3lBluQF1745761280.mp3", "video": ""}, {"text": "Which of the following accurately describes the stages of MRI image acquisition?", "options": [{"label": "A", "text": "Protons align uniformly, get excited, and relax, emitting radiation.", "correct": true}, {"label": "B", "text": "Protons align randomly and emit radiation upon excitation.", "correct": false}, {"label": "C", "text": "Protons rest and emit radiation continuously without excitation.", "correct": false}, {"label": "D", "text": "Excited protons emit radiation before aligning with the magnetic field.", "correct": false}], "correct_answer": "A. Protons align uniformly, get excited, and relax, emitting radiation.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/m3RFq6FhbfDO8cnbxEQy1743785612.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/BcgPzWWQ0Tgr3uhOqHwV1745761437.mp3", "video": ""}, {"text": "Which statements correctly describe the differences between T1 and T2 relaxation in MRI?", "options": [{"label": "A", "text": "T1 measures transverse decay; T2 measures longitudinal recovery.", "correct": false}, {"label": "B", "text": "T1 involves energy exchange; T2 involves loss of phase coherence.", "correct": true}, {"label": "C", "text": "T1 relaxation is typically shorter in duration than T2", "correct": false}, {"label": "D", "text": "Longer T1 appears Brighter &amp;amp; Longer T2 appears Darker", "correct": false}], "correct_answer": "B. T1 involves energy exchange; T2 involves loss of phase coherence.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/MFrIL3Zopxoq0OlZwAiJ1743785699.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:654px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parameter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T1-Weighted MRI</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T2-Weighted MRI</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is time for <strong>longitudinal magnetisation to recover</strong> to its <span class=\"customMeta\" data-dictid=\"d52b8551541692777187be85e4bb2f\">equilibrium</span> after excitation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is time for <strong>transverse magnetisation to decay.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Involves <strong>energy exchange</strong> between spins and surrounding environment (spin-lattice interaction)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Involves <strong>loss of phase coherence</strong> among spins (spin-spin interaction)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tissue Assessment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Useful for assessing<strong> fat</strong> content in tissues (e.g., <strong>brain white matter</strong>)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Useful for assessing <strong>water</strong> content in tissues (e.g., <strong>cerebrospinal fluid</strong>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tissue Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Darker for longer T1, brighter for shorter T1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Brighter for longer T2, darker for shorter T2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bright Area Significance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bright areas indicate tissues with <strong>shorter T1 times</strong> (e.g., fat-rich tissues)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bright areas indicate tissues with <strong>longer T2 times</strong> (e.g., fluid-rich tissues)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Time Range</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microseconds to seconds</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Typically shorter than T1</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lXxNQJ4Hu9idqte5w04J1745850885.mp3", "video": ""}, {"text": "Match the following: 1) a) FLAIR 2) b) Diffusion-weighted MRI 3) c) T1-Weighted MRI 4) d) T2-Weighted MRI", "options": [{"label": "A", "text": "1-c, 2-d, 3-a, 4-b", "correct": true}, {"label": "B", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "C", "text": "1-b, 2-c, 3-d, 4-a", "correct": false}, {"label": "D", "text": "1-d, 2-a, 3-b, 4-c", "correct": false}], "correct_answer": "A. 1-c, 2-d, 3-a, 4-b", "question_images": ["https://image.prepladder.com/notes/5hssM2XlIhNM7jPTCVRe1743786652.png", "https://image.prepladder.com/notes/bKZABmBFsCLHa2G3FiR71743786686.png", "https://image.prepladder.com/notes/0f2nrwTopswwJ7YLQFLj1743786723.png", "https://image.prepladder.com/notes/QzgOLuMs5sj8vLYsb7ly1743786764.png"], "explanation_images": ["https://image.prepladder.com/notes/DoR8yxmM9Dbe0Cv2MGao1743786817.png", "https://image.prepladder.com/notes/MKUHnBoSmGYlw9qCly1H1743786869.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:695px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tissue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T1-Weighted</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T2-Weighted</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>FLAIR</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CSF</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dark</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bright</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dark</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>White matter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Light</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dark gray</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dark gray</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cortex</strong></p>\n<p><strong>(Gray matter)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gray</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Light gray</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Light gray</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fat</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bright</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Light</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Light</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inflammation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dark</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bright</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bright</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Bm7PJ7sMyu8IpWk2TmyH1745851116.mp3", "video": ""}, {"text": "A 65-year-old patient presents with cognitive decline and movement difficulties. Imaging studies reveal iron deposition in the basal ganglia. The neurologist wants to confirm the extent of iron accumulation and assess for any associated microbleeds. Which MRI technique is preferred for evaluating iron deposition in this patient?", "options": [{"label": "A", "text": "Susceptibility-Weighted Imaging (SWI)", "correct": true}, {"label": "B", "text": "Diffusion-Weighted Imaging (DWI)", "correct": false}, {"label": "C", "text": "Functional MRI (fMRI)", "correct": false}, {"label": "D", "text": "MR Spectroscopy", "correct": false}], "correct_answer": "A. Susceptibility-Weighted Imaging (SWI)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/oGumhXsWEcFu2IyBdMmC1743786958.png", "https://image.prepladder.com/notes/g8FWZcbfHjGYmNat4Rz51743786991.png", "https://image.prepladder.com/notes/HJSCD6vmHkmt3y5E6dzO1743787138.png", "https://image.prepladder.com/notes/hfai9YryLPqGCl5BlGdL1743787178.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/SNeYkaOEiZf7GbnBVHzf1745851369.mp3", "video": ""}, {"text": "A 60-year-old patient is scheduled for an MRI to evaluate cognitive changes. Which of the following systems is specifically designed to provide shielding against radio frequency interference during the scan?", "options": [{"label": "A", "text": "Gradient coils", "correct": false}, {"label": "B", "text": "Helmholtz coils", "correct": false}, {"label": "C", "text": "Shim coils", "correct": false}, {"label": "D", "text": "Faradayâs cage", "correct": true}], "correct_answer": "D. Faradayâs cage", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/nY25SbxoX8OEMTq3ewhw1743787443.png", "https://image.prepladder.com/notes/u1Bwh6mwj1JHN3MqNtJH1743787472.png", "https://image.prepladder.com/notes/eINgcwgeFNYQitrd1tEq1743787505.png", "https://image.prepladder.com/notes/phTkWi6J948l93Yl6j4M1743787552.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/cy3Y4mnkbENnH4xq4Krn1745851781.mp3", "video": ""}, {"text": "A 70-year-old patient requires arterial access via the femoral artery using the Seldinger technique. After sterilizing the area, the physician successfully punctures the artery with a needle. What is the next step in the Seldinger technique?", "options": [{"label": "A", "text": "Secure the catheter", "correct": false}, {"label": "B", "text": "Insert a dilator through the needle", "correct": false}, {"label": "C", "text": "Insert a guide wire through the needle", "correct": true}, {"label": "D", "text": "Remove the needle and insert a dilator", "correct": false}], "correct_answer": "C. Insert a guide wire through the needle", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ddXfU4dmPKsfsy8Kpcht1745577524.png", "https://image.prepladder.com/notes/bZzpZeZjWOKGBtzvT8hz1745577449.png", "https://image.prepladder.com/notes/FCdjqkr3TRA6W8VZsVQN1745577367.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TRQoGi0SJMuRrlWb24mE1745851977.mp3", "video": ""}, {"text": "A 55-year-old female presents with 6 months of heavy menstrual bleeding, pelvic pressure, and frequent urination due to multiple uterine fibroids. After failed conservative treatments and a history of hypertension and obesity, uterine fibroid embolisation (UFE) is planned, and the risks have been explained. Which of the following is not an advantage of the single wall puncture technique?", "options": [{"label": "A", "text": "Fewer complications at the arterial puncture site", "correct": false}, {"label": "B", "text": "Beneficial for patients with coagulopathy", "correct": false}, {"label": "C", "text": "Less risk of arterial dissection", "correct": true}, {"label": "D", "text": "A favored technique for ultrasound-guided access", "correct": false}], "correct_answer": "C. Less risk of arterial dissection", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/6Sv9RwzGlQEoj6EYgxwf1743788162.png", "https://image.prepladder.com/notes/fMYlv6qcVkttDi4gCleF1743788212.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:752px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Single-wall <span class=\"customMeta\" data-dictid=\"9af4bb5919169277719688aaf3f8e7\">Puncture</span> Technique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Double-wall <span class=\"customMeta\" data-dictid=\"9af4bb5919169277719688aaf3f8e7\">Puncture</span> Technique</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Description</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Puncturing only one layer (tunica intima) of the arterial wall.</p>\n<p><img alt=\"RA021\" data-author=\"\" data-hash=\"7566\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/6Sv9RwzGlQEoj6EYgxwf1743788162.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n<p><img alt=\"RA023\" data-author=\"\" data-hash=\"7567\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/fMYlv6qcVkttDi4gCleF1743788212.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:121px\">\n<p style=\"text-align:center\"><strong>Advantages </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:300px\">\n<ul>\n<li>Fewer complications at the arterial <span class=\"customMeta\" data-dictid=\"9af4bb5919169277719688aaf3f8e7\">puncture</span> site. <strong>(Option A)</strong></li>\n<li>Beneficial for patients with coagulopathy. <strong>(Option B)</strong></li>\n<li>A favored technique for ultrasound-guided access. <strong>(Option D)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:331px\">\n<ul>\n<li>Decreases the time required for arterial access.</li>\n<li>Decreases the number of attempts needed.</li>\n<li><strong>Decreased risk of arterial dissection.</strong></li>\n<li>It can strike the bony landmark located behind the vessels (such as the <span class=\"customMeta\" data-dictid=\"ab8a987431169277720229e09c01d7\">femoral</span> head).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:121px\">\n<p style=\"text-align:center\"><strong>Disadvantages </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:300px\">\n<p>The <strong>risk of arterial <span class=\"customMeta\" data-dictid=\"e42da316b916927771860f0ba81c19\">dissection</span> may increase</strong> due to <span class=\"customMeta\" data-dictid=\"e2da83abd61692777188616dd64e87\">guidewire</span> <span class=\"customMeta\" data-dictid=\"2cdd3187321692777183fb22d77cfb\">buckling</span> if it is only partially within the lumen.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:331px\">\n<p>Prone to complications such as:</p>\n<ul>\n<li>Hematoma</li>\n<li>Arteriovenous fistula</li>\n<li>Retroperitoneal hemorrhage</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/t4kqK2rkIBifCsurPH8B1745852639.mp3", "video": ""}, {"text": "A 55-year-old male with chronic bronchitis and smoking presents with persistent hemoptysis. After consulting a specialist, he is advised to undergo bronchial artery embolization (BAE), and the risks are explained. He wants more details about the procedure, specifically regarding the types of embolic agents used. Which of the following is not a permanent type of embolic agent?", "options": [{"label": "A", "text": "Injectable coil", "correct": false}, {"label": "B", "text": "Onyx", "correct": false}, {"label": "C", "text": "Polyvinyl alcohol", "correct": false}, {"label": "D", "text": "Gelfoam", "correct": true}], "correct_answer": "D. Gelfoam", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/VApixx07EezKEG4Gpo9f1743788347.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8SyWGLrF56S8sYq07s3l1745853276.mp3", "video": ""}, {"text": "Match the following imaging modalities with their corresponding terms. Imaging Modality Terms 1. X-ray a) Hypoechoic / Hyperechoic 2. CT (Computed Tomography) b) Hypointense / Hyperintense 3. MRI (Magnetic Resonance Imaging) c) Radiolucent / Opaque 4. USG (Ultrasound) d) Hypodense / Hyperdense", "options": [{"label": "A", "text": "1-b, 2-d, 3-c, 4-a", "correct": false}, {"label": "B", "text": "1-c, 2-d, 3-b, 4-a", "correct": true}, {"label": "C", "text": "1-a, 2-b, 3-d, 4-c", "correct": false}, {"label": "D", "text": "1-c, 2-d, 3-a, 4-b", "correct": false}], "correct_answer": "B. 1-c, 2-d, 3-b, 4-a", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/v6PQ3v1CrC9FhyuTsXso1745853980.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 20 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "What is the primary difference between axial and helical CT scanning?", "options": [{"label": "A", "text": "Axial CT uses contrast agents, while helical CT does not.", "correct": false}, {"label": "B", "text": "Axial CT scans in single slices, while helical CT scans continuously in a spiral.", "correct": true}, {"label": "C", "text": "Helical CT requires more radiation than axial CT.", "correct": false}, {"label": "D", "text": "Axial CT produces 3D images, while helical CT produces 2D images.", "correct": false}], "correct_answer": "B. Axial CT scans in single slices, while helical CT scans continuously in a spiral.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Axial CT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Helical CT</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Axial CT scans acquire images in <span class=\"customMeta\" data-dictid=\"635650799116927771862d7cb568f4\">discrete</span> slices or cross-sections of the body. The <span class=\"customMeta\" data-dictid=\"699a8762f1169277719832609cf10a\">scanner</span> rotates around the patient, capturing one slice at a time.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Helical CT scans acquire images continuously in a <span class=\"customMeta\" data-dictid=\"0b34a9891d16927771998a84595013\">spiral</span> pattern as the patient moves through the scanner.</li>\n<li>This allows for a continuous data stream and overlapping slices.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Data Acquisition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>The table holding the patient moves in small increments between scans.</li>\n<li>After each slice is acquired, the table stops to allow for the next slice to be taken.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"699a8762f1169277719832609cf10a\">scanner</span> rotates around the patient while the table moves through the gantry simultaneously, resulting in a <span class=\"customMeta\" data-dictid=\"0b34a9891d16927771998a84595013\">spiral</span> path of data collection.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Scan Time </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>Generally longer due to the stepwise approach, as the table must move and stop for each slice.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>Much faster than <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> CT, as the entire area can be scanned in a single breath-hold, which is beneficial for patients who may have difficulty remaining still.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image Quality </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>Typically provides high-resolution images, making it <strong>ideal for detailed examinations, especially of the brain </strong>and other structures.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>Provides good quality images and can be processed for <strong>3D reconstructions</strong>, making it useful for dynamic studies and quick imaging.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Advantages </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>High-resolution images, ideal for detailed examinations.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>Faster scans, less motion artifact, and the ability to reconstruct images in multiple planes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Disadvantages </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>Longer scan times and may be less effective for dynamic imaging.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>May require higher radiation doses depending on parameters and can have slightly lower image resolution compared to <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> scans.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:627px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Axial CT </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Helical CT </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acquisition</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Single slices, stepwise motion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Continuous, <span class=\"customMeta\" data-dictid=\"0b34a9891d16927771998a84595013\">spiral</span> motion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Scan Time</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Longer scan time</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Faster scan time</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Image Quality</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High resolution</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Good quality, can create 3D images</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clinical Use</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Detailed examinations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Emergency cases, dynamic studies</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following imaging modalities requires the use of iodinated contrast for both diagnostic and therapeutic purposes?", "options": [{"label": "A", "text": "CT Angiography", "correct": false}, {"label": "B", "text": "MRA", "correct": false}, {"label": "C", "text": "DSA - Fluoroscopy", "correct": true}, {"label": "D", "text": "Both A and C", "correct": false}], "correct_answer": "C. DSA - Fluoroscopy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/KodXqN5xEpPMExbpqRpd1743783131.png", "https://image.prepladder.com/notes/W3jT7ph0hPDcLaxwMJXh1743783184.png", "https://image.prepladder.com/notes/CLfzHISchYS9YYS29mxh1743783241.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:640px\">\n<thead>\n<tr>\n<th scope=\"col\" style=\"vertical-align:top\"> </th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>CT Angiography</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>MRA</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>DSA - Fluoroscopy</strong></p>\n</th>\n</tr>\n<tr>\n<th scope=\"col\" style=\"vertical-align:top\"><strong>Vessels</strong></th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p style=\"text-align:left\">White</p>\n<p style=\"text-align:left\"><img alt=\"RA929\" data-author=\"\" data-hash=\"7536\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/KodXqN5xEpPMExbpqRpd1743783131.png\"/></p>\n</th>\n<th scope=\"col\" style=\"text-align:left; vertical-align:top\">\n<p>White</p>\n<p><img alt=\"RA930\" data-author=\"\" data-hash=\"7537\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/W3jT7ph0hPDcLaxwMJXh1743783184.png\"/></p>\n</th>\n<th scope=\"col\" style=\"text-align:left; vertical-align:top\">\n<p>Black/white (fluoroscopy gives inverted images).</p>\n<p><img alt=\"RA930\" data-author=\"\" data-hash=\"7538\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/CLfzHISchYS9YYS29mxh1743783241.png\"/></p>\n</th>\n</tr>\n<tr>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Contrast</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p>Essential</p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<ul>\n<li style=\"text-align:left\">It <strong>can be done without contrast</strong>. TOF sequence (time of flight)</li>\n<li>It<strong> can be used in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure patients.</strong> (without gadolinum since <span class=\"customMeta\" data-dictid=\"e3767003061692777187b931c6a08f\">gadolinium</span> is nephrotoxic)</li>\n</ul>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p>Essential</p>\n</th>\n</tr>\n<tr>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Type of contrast</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p>Iodinated contrast</p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p>Gadolinium</p>\n<p><strong>(Option B ruled out)</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p>Iodinated contrast</p>\n</th>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:97px\">\n<p><strong>Route of contrast</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:161px\">\n<ul>\n<li>IV</li>\n<li>Non-invasive</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:179px\">\n<ul>\n<li>IV</li>\n<li>Non-invasive</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:203px\">\n<ul>\n<li>Intra-arterial contrast (catheter angiography)</li>\n<li>Invasive.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:97px\">\n<p><strong>Application</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:161px\">\n<p>Diagnostic</p>\n<p><strong>(Option A and D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:179px\">\n<p>Diagnostic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:203px\">\n<p>Both <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> and <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> <strong>(Option C)</strong></p>\n</td>\n</tr>\n</thead>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 38 year old woman presents with chronic pelvic pain and menorrhagia due to multiple uterine fibroids. She is exploring non-invasive treatment options and wishes to avoid surgery. Her gynecologist suggests high-intensity focused ultrasound (HIFU) as a potential treatment. What is the primary mechanism by which HIFU treats uterine fibroids?", "options": [{"label": "A", "text": "HIFU emits continuous low-energy ultrasound waves that dissolve fibroid tissue through vibration.", "correct": false}, {"label": "B", "text": "HIFU directs focused ultrasound energy to induce thermal damage and coagulation necrosis within the fibroid.", "correct": true}, {"label": "C", "text": "HIFU causes cavitation within blood vessels, disrupting the fibroidâs blood supply and leading to ischemia.", "correct": false}, {"label": "D", "text": "HIFU uses ultrasound energy to fragment fibroid tissue through mechanical shearing forces.", "correct": false}], "correct_answer": "B. HIFU directs focused ultrasound energy to induce thermal damage and coagulation necrosis within the fibroid.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:680px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Therapeutic applications of USG- High-intensity focused <span class=\"customMeta\" data-dictid=\"b93d06140916927772017ebc71db88\">ultrasonography</span> (HIFU)</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mechanism</p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Uses high-intensity <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> waves focused on a specific target area, delivering <span class=\"customMeta\" data-dictid=\"8fb8df140b1692777191702bbc9358\">localized</span> energy while minimizing damage to surrounding tissues.</li>\n</ul>\n<ul>\n<li>Thermal Effects: Heat from <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> energy leads to <span class=\"customMeta\" data-dictid=\"42f1e4deb8169277718412c0681a54\">coagulation</span> necrosis.</li>\n<li>Cavitation Effects: Formation and collapse of <span class=\"customMeta\" data-dictid=\"765399221b1692777192562a473adc\">microbubbles</span> generate mechanical forces for tissue destruction.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Applications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bleeding Sites: Coagulates vessels to stop bleeding.</li>\n<li>Uterine Fibroids: Induces <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> in <span class=\"customMeta\" data-dictid=\"6dc32fa81216927772024a5075bf66\">fibroid</span> tissue, causing shrinkage.</li>\n<li>Tumours: Destroys tumour cells in organs like the prostate, liver and breast while sparing healthy tissues.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limitations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gas or Bone Interference: <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">Ultrasound</span> waves can be scattered or <span class=\"customMeta\" data-dictid=\"014b1a7b931692777197f57251720d\">reflected</span> by gas or bone, reducing effectiveness.</li>\n<li>Unintended Tissue Damage: Heating and damage can occur to normal tissue, especially near reflectors like <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> gas or bone.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Guidance Systems</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ultrasound Guidance: <span class=\"customMeta\" data-dictid=\"9ddd195e9a1692777197bb3f135c2e\">Real-time</span> <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> for accurate targeting.</li>\n<li>MRI Guidance: Monitors tissue temperature during treatment, allowing better control of <span class=\"customMeta\" data-dictid=\"e316517c941692777200eb2671128d\">thermal</span> effects.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 62 year old woman with a history of hepatic metastases undergoes an ultrasound study using contrast-enhanced ultrasonography (CEUS) for liver lesion characterization. CEUS employs microbubbles that improve imaging of small vessels and capillaries. Which of the following is a primary advantage of CEUS compared to traditional contrast-enhanced CT or MRI?", "options": [{"label": "A", "text": "CEUS allows targeted drug delivery in specific lesions", "correct": false}, {"label": "B", "text": "CEUS allows real-time imaging with enhanced lesion detection", "correct": false}, {"label": "C", "text": "CEUS is a safe alternative for patients with renal impairment", "correct": true}, {"label": "D", "text": "All the above", "correct": false}], "correct_answer": "C. CEUS is a safe alternative for patients with renal impairment", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:753px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contrast-Enhanced <span class=\"customMeta\" data-dictid=\"b93d06140916927772017ebc71db88\">Ultrasonography</span> (CEUS)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Basic Principle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Uses <span class=\"customMeta\" data-dictid=\"765399221b1692777192562a473adc\">microbubbles</span> (3-5 Âľm) as contrast agents</li>\n<li>Microbubbles contain gases (air, nitrogen, perfluorocarbons) which are <span class=\"customMeta\" data-dictid=\"e26ba9a1d41692777187d0ad03a8c1\">encapsulated</span> in <span class=\"customMeta\" data-dictid=\"1fa594dc2b169277718104d76aa4e2\">albumin</span> or <span class=\"customMeta\" data-dictid=\"a3a38a650a16927771959a6595f93a\">phospholipid</span> shells</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mechanism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microbubbles create <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> <span class=\"customMeta\" data-dictid=\"5506888d131692777189948dbb6f26\">impedance</span> mismatch</p>\n<p>â</p>\n<p>Generate nonlinear harmonic frequencies</p>\n<p>â</p>\n<p>Enables <span class=\"customMeta\" data-dictid=\"33ba8d60fb16927772029d1067e602\">visualization</span> of small vessels/capillaries</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Liver <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> characterization</li>\n<li>Intervention guidance</li>\n<li>Treatment response monitoring</li>\n<li>Vascular flow assessment</li>\n<li>Non-vascular uses (e.g., <span class=\"customMeta\" data-dictid=\"a970a38e85169277720171bea632e7\">tubal</span> patency)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Advantages / Limitations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Advantages\n\t\t\t\t<ul>\n<li>Enhanced <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> detection</li>\n<li>Potential for targeted drug delivery</li>\n<li>Safe alternative to CT/MRI contrast</li>\n<li>Enables non-invasive pressure measurements</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45 year old woman presents to the emergency department with dull abdominal pain. An ultrasound of the abdomen is performed, and a cystic structure is seen in the right kidney. The ultrasound technician notes increased echogenicity behind the cystic structure. Which of the following best explains this ultrasound finding?", "options": [{"label": "A", "text": "Posterior Acoustic shadowing", "correct": false}, {"label": "B", "text": "Posterior acoustic enhancement", "correct": true}, {"label": "C", "text": "Reverberation artifact", "correct": false}, {"label": "D", "text": "Comet tail artifact", "correct": false}], "correct_answer": "B. Posterior acoustic enhancement", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/jkBD7qL7dTLu5N97sh3t1743782814.png", "https://image.prepladder.com/notes/1Ym0Y3eTw1dtGamxtfmP1743782858.png", "https://image.prepladder.com/notes/SLcSNzWEiDxwHSxQy8rs1743782933.png", "https://image.prepladder.com/notes/Mfft1QWWblu6dzwwmPrl1743782981.png"], "explanation": "<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"text-align:center\">\n<p><strong>Black and white principles of USG</strong></p>\n<p><img alt=\"RA925\" data-author=\"\" data-hash=\"7532\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/jkBD7qL7dTLu5N97sh3t1743782814.png\"/></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Posterior <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">Acoustic</span> Enhancement</strong></p>\n<img alt=\"RA926\" data-author=\"\" data-hash=\"7533\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/1Ym0Y3eTw1dtGamxtfmP1743782858.png\"/></td>\n<td>\n<ul>\n<li>Ultrasound artifact where tissues behind fluid appear brighter</li>\n<li>Occurs because fluid causes less <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> of <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> waves</li>\n<li>Mechanism:</li>\n</ul>\n<p style=\"text-align:center\">Ultrasound beam encounters fluid-filled structure</p>\n<p style=\"text-align:center\">â</p>\n<p style=\"text-align:center\">Less energy lost passing through fluid vs. surrounding tissue</p>\n<p style=\"text-align:center\">â</p>\n<p style=\"text-align:center\">More energy reaches tissues behind fluid</p>\n<p style=\"text-align:center\">â</p>\n<p style=\"text-align:center\">Result: Increased <span class=\"customMeta\" data-dictid=\"90fde6a24316927771869acda3aa9c\">echogenicity</span> (brightness) <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> to fluid</p>\n<p> </p>\n<ul>\n<li>Helpful For Identifying:\n\t\t\t\t<ul>\n<li>Cysts</li>\n<li>Bladder</li>\n<li>Ascites</li>\n<li>Other fluid-filled structures</li>\n</ul>\n</li>\n<li>Can cause misinterpretation:\n\t\t\t\t<ul>\n<li>Example: Kidneys viewed through <span class=\"customMeta\" data-dictid=\"a1146fb9d8169277718250cf1224a8\">ascites</span> may appear falsely hyperechoic</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Posterior <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">Acoustic</span> shadowing</strong></p>\n<p><strong>(Option A ruled out)</strong></p>\n<img alt=\"RA927\" data-author=\"\" data-hash=\"7534\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/SLcSNzWEiDxwHSxQy8rs1743782933.png\"/><br/>\n\t\t\t </td>\n<td>\n<ul>\n<li>Ultrasound artifact appearing as dark area behind highly attenuating structures</li>\n<li>Results from significant reduction in <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> intensity</li>\n<li>Mechanism:</li>\n</ul>\n<p style=\"text-align:center\">Ultrasound beam hits highly reflective/attenuating structure</p>\n<p style=\"text-align:center\">â</p>\n<p style=\"text-align:center\">Most sound waves are blocked or reflected</p>\n<p style=\"text-align:center\">â</p>\n<p style=\"text-align:center\">Little to no energy reaches tissues behind structure</p>\n<p style=\"text-align:center\">â</p>\n<p style=\"text-align:center\">Result: Dark (hypoechoic) area appears on image</p>\n\t\t\t \n\n\t\t\t<ul>\n<li>Helpful For Identifying:\n\t\t\t\t<ul>\n<li>Calcifications</li>\n<li>Stones</li>\n<li>Foreign bodies</li>\n<li>Bone</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45 year old female patient presents for a carotid Doppler ultrasound due to complaints of transient ischemic attacks. During the examination, the radiologist notices that the displayed velocity of blood flow in the carotid artery appears higher than expected. Upon reviewing the images, he suspects an artifact affecting the velocity measurements. Which artifact is most likely responsible for the incorrect velocity display, and what is the best method to mitigate it?", "options": [{"label": "A", "text": "Aliasing; mitigate by increasing the pulse repetition frequency (PRF).", "correct": true}, {"label": "B", "text": "Blooming; mitigate by increasing the wall filter settings.", "correct": false}, {"label": "C", "text": "Direction Ambiguity; mitigate by adjusting the beam angle to be more parallel to the flow.", "correct": false}, {"label": "D", "text": "Twinkle Artifact; mitigate by adjusting the color gain settings.", "correct": false}], "correct_answer": "A. Aliasing; mitigate by increasing the pulse repetition frequency (PRF).", "question_images": [], "explanation_images": [], "explanation": "<table>\n<thead>\n<tr>\n<th><strong>Artifact</strong></th>\n<th><strong>Appearance</strong></th>\n<th><strong>Best Solution</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td><strong>Aliasing</strong></td>\n<td>Wrap-around <span class=\"customMeta\" data-dictid=\"19d250592b1692777202f372a17f05\">waveform</span> or reversed color</td>\n<td><strong>Increase PRF</strong>, lower frequency, shift baseline</td>\n</tr>\n<tr>\n<td>Blooming</td>\n<td>Overfilled color/velocity extending beyond vessel wall</td>\n<td>Reduce gain, optimize wall filters</td>\n</tr>\n<tr>\n<td>Direction Ambiguity</td>\n<td>Flow appears in both directions</td>\n<td>Use angle correction, reduce sample volume</td>\n</tr>\n<tr>\n<td>Twinkle Artifact</td>\n<td>Color speckling behind calcified area</td>\n<td>Lower color gain or change angle</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:759px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old patient presents to the emergency department with chest pain and shortness of breath following a traumatic injury. M-mode ultrasound is utilized to assess pneumothorax. Which specific ultrasound finding would indicate the absence of a pneumothorax?", "options": [{"label": "A", "text": "Absence of pleural sliding", "correct": false}, {"label": "B", "text": "Barcode sign (stratosphere sign)", "correct": false}, {"label": "C", "text": "Absence of diaphragmatic movement", "correct": false}, {"label": "D", "text": "Seashore sign", "correct": true}], "correct_answer": "D. Seashore sign", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/JOFkgIxywqmwdD1AN3v11743782362.png", "https://image.prepladder.com/notes/6wJLKraISvsw283QfxvH1743782396.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:730px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>M-mode Ultrasound</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>M-mode (Motion mode) uses a rapid sequence of B-mode scans to track organ movement relative to the probe.</li>\n<li>It captures motion over time, providing clinicians with a dynamic view of structure movements, which is crucial for assessing processes that <span class=\"customMeta\" data-dictid=\"0e0dce452a1692777198212234f2f0\">static</span> 2D <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> cannot.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Applications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Pneumothorax</strong>: Detects air in the pleural space by visualizing pleural movement.</li>\n<li><strong>Left <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">Ventricular</span> Function</strong>: Assesses heart performance via measurements like E-point septal separation.</li>\n<li><strong>Cardiac Tamponade</strong>: Detects fluid around the heart.</li>\n<li><strong>Hypertrophic Cardiomyopathy</strong>: Evaluates <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> thickening of the heart muscle.</li>\n<li><strong>Diaphragmatic Kinetics</strong>: Reliable for measuring <span class=\"customMeta\" data-dictid=\"06ff18f51216927771867fe1461a04\">diaphragmatic</span> movement, both at rest and during forced breathing.</li>\n<li><strong>Echocardiography</strong>: Measures heart function through <span class=\"customMeta\" data-dictid=\"d93de7238d16927771922b27cb6086\">mitral</span> (MAPSE) and <span class=\"customMeta\" data-dictid=\"3ab13cdf64169277720085e2ebef1c\">tricuspid</span> (TAPSE) <span class=\"customMeta\" data-dictid=\"96f5104d6816927771816ac8dfceeb\">annular</span> plane <span class=\"customMeta\" data-dictid=\"cf69f5256416927771991c21f264ae\">systolic</span> excursions.</li>\n<li><strong>Volume Status:</strong> Evaluates fluid status via <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> and superior <span class=\"customMeta\" data-dictid=\"3ddf6d5ea71692777201b70c8b9715\">vena</span> <span class=\"customMeta\" data-dictid=\"67544ba6ef16927771835d4641cc8f\">cava</span> diameters.</li>\n<li>Identifies issues like <strong>systolic <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> motion</strong> of the <span class=\"customMeta\" data-dictid=\"d93de7238d16927771922b27cb6086\">mitral</span> <span class=\"customMeta\" data-dictid=\"416dd1004a169277720177d9a6adc5\">valve</span> and <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> tamponade.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Advantages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>High <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> resolution, offering precise timing of motion.</li>\n<li>Quick and easy to perform, even for less experienced users.</li>\n<li>Applicable across various clinical settings.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements accurately distinguishes between A-scan from B-scan ultrasound in ophthalmology?", "options": [{"label": "A", "text": "A-scan provides a two-dimensional image, while B-scan provides a one-dimensional image.", "correct": false}, {"label": "B", "text": "A-scan is primarily used to measure axial length, whereas B-scan is used to visualize internal ocular structures.", "correct": true}, {"label": "C", "text": "B-scan displays spikes on a graph, while A-scan displays a dotted section of the eyeball.", "correct": false}, {"label": "D", "text": "A-scan requires the probe to be applied on the eyelids, while B-scan requires direct contact with the cornea.", "correct": false}], "correct_answer": "B. A-scan is primarily used to measure axial length, whereas B-scan is used to visualize internal ocular structures.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zc9UfrsBO0rHak3Ng3Pl1743782184.png", "https://image.prepladder.com/notes/QBKQov5pSZ0VVcM0jnch1743782228.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A-Scan (Time Amplitude)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>B-Scan (Intensity Modulation)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dimension</strong></p>\n<p><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>One-dimensional</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Two-dimensional</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Probe size</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Smaller</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Larger</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Method</strong></p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The patient's eye is numbed with <span class=\"customMeta\" data-dictid=\"4b83ec31581692777181547f1a89ef\">anesthetic</span> drops, and a small <span class=\"customMeta\" data-dictid=\"5ef5bf3cf91692777180fcdd4bde7b\">A-scan</span> <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> is applied to the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> to collect measurements.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The B scan <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> is softly positioned on the eyelids as the patient gazes in different directions to obtain various angles.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Measures <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Visualizes internal structures</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Display</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Spikes on graph</li>\n<li>Interpretation:\n\t\t\t\t<ul>\n<li>Spike distance = tissue measurement</li>\n<li>Spike height = tissue density</li>\n<li>High spikes: cornea, lens, sclera</li>\n<li>Low spikes: <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> structures</li>\n</ul>\n</li>\n</ul>\n<p><img alt=\"RA920\" data-author=\"\" data-hash=\"7527\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/zc9UfrsBO0rHak3Ng3Pl1743782184.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dotted section of eyeball</p>\n<p><img alt=\"RA921\" data-author=\"\" data-hash=\"7528\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/QBKQov5pSZ0VVcM0jnch1743782228.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:90px\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:272px\">\n<ul>\n<li>IOL power calculation (biometry)</li>\n<li>Anterior chamber depth measurement</li>\n<li>Intraocular mass <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> assessment</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:262px\">\n<ul>\n<li>Posterior segment evaluation with <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> media</li>\n<li>Tumor assessment:\n\t\t\t\t<ul>\n<li>Intraocular</li>\n<li>Orbital</li>\n</ul>\n</li>\n<li>Foreign body localization:\n\t\t\t\t<ul>\n<li>Intraocular</li>\n<li>Intraorbital</li>\n</ul>\n</li>\n<li>Advantage: Easier interpretation of structure location/size</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match each type of ultrasound probe with its primary use. Probe Primary Use 1) a) Vascular, high-resolution imaging 2) b) Cardiac, endocavitary, neonatal brain 3) c) Abdominal, OBS/GYN", "options": [{"label": "A", "text": "1b,2a,3c", "correct": true}, {"label": "B", "text": "1a,2b,3c", "correct": false}, {"label": "C", "text": "1c,2a,3b", "correct": false}, {"label": "D", "text": "1a,2c,3b", "correct": false}], "correct_answer": "A. 1b,2a,3c", "question_images": ["https://image.prepladder.com/notes/E5qlFpcNi12VXMJvgsE11743781739.png", "https://image.prepladder.com/notes/SaJvI15Z4L8MFUVIPar71743781761.png", "https://image.prepladder.com/notes/E1XgRcn87TDbJ5J8y7xe1743781792.png"], "explanation_images": ["https://image.prepladder.com/notes/SaJvI15Z4L8MFUVIPar71743781761.png", "https://image.prepladder.com/notes/E1XgRcn87TDbJ5J8y7xe1743781792.png", "https://image.prepladder.com/notes/E5qlFpcNi12VXMJvgsE11743781739.png"], "explanation": "<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"text-align:center\"><strong>Types of <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">Ultrasound</span> Transducers/ Probes</strong></td>\n</tr>\n<tr>\n<td><strong>Linear</strong></td>\n<td>\n<ul>\n<li>Shape: Rectangular/parallelogram image</li>\n<li>Use:<strong> Vascular, high-resolution imaging</strong></li>\n</ul>\n<img alt=\"RA918\" data-author=\"\" data-hash=\"7525\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"734\" src=\"https://image.prepladder.com/notes/SaJvI15Z4L8MFUVIPar71743781761.png\" width=\"400\"/></td>\n</tr>\n<tr>\n<td>\n<p><strong>Convex</strong></p>\n</td>\n<td>\n<ul>\n<li>Shape: Sector image, curved top</li>\n<li>Use: <strong>Abdominal, OBS/ GYN</strong></li>\n</ul>\n<img alt=\"RA919\" data-author=\"\" data-hash=\"7526\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"627\" src=\"https://image.prepladder.com/notes/E1XgRcn87TDbJ5J8y7xe1743781792.png\" width=\"400\"/></td>\n</tr>\n<tr>\n<td><strong>Phased Array</strong></td>\n<td>\n<ul>\n<li>Shape: Sector image, pointed top</li>\n<li>Use: <strong>Cardiac (fits between ribs), endocavitary (like endovaginal), <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> brain</strong></li>\n</ul>\n<img alt=\"RA917\" data-author=\"\" data-hash=\"7524\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"740\" src=\"https://image.prepladder.com/notes/E5qlFpcNi12VXMJvgsE11743781739.png\" width=\"400\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:152px\">\n<p><strong>Vector/ Trapezoidal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:430px\">\n<ul>\n<li>Shape: Trapezoidal image</li>\n<li>Use: <strong>Abdominal, cardiac, Doppler</strong></li>\n<li>Features: <span class=\"customMeta\" data-dictid=\"b3c8df9e991692777189929b113142\">Hybrid</span> of <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">linear</span> &amp; phased</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:198px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ultrasound Transducers/ Probes</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Uses piezoelectric crystals to convert electrical â sound energy</li>\n<li>Frequency choice: Depth dependent\n\t\t\t\t<ul>\n<li>Lower (3.5 MHz) = deeper tissues</li>\n<li>Higher (5+ MHz) = superficial/pediatric</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Key Principles\n\t\t\t\t<ul>\n<li>Frequency â 1/crystal thickness</li>\n<li>Higher frequency = less <span class=\"customMeta\" data-dictid=\"31dd0b58bb1692777195e6016ecd51\">penetration</span> but better resolution</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the primary reason for applying ultrasound gel during an ultrasound examination?", "options": [{"label": "A", "text": "To enhance image contrast", "correct": false}, {"label": "B", "text": "To act as a lubricant for easier probe movement", "correct": false}, {"label": "C", "text": "To eliminate air pockets between the probe and skin", "correct": true}, {"label": "D", "text": "To cool down the transducer while in constant use", "correct": false}], "correct_answer": "C. To eliminate air pockets between the probe and skin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ultrasound Gel</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose of Gel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Eliminates air pockets between <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> and skin</strong><strong> </strong>for <strong>effective </strong>sound transmission. <strong>(Option C)</strong></li>\n<li>Serves as a medium for sound and lubricant.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Preferred Gel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Hydrogel </strong>is preferred over Lipogel for easier cleaning.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ingredients</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Distilled water, carbomer, <span class=\"customMeta\" data-dictid=\"7f4fb60ca816927771876ae5f619eb\">ethylenediaminetetraacetic acid</span> (EDTA), <span class=\"customMeta\" data-dictid=\"e2c0074e9c1692777196b2028a4274\">propylene</span> glycol, glycerin, trolamine, and occasionally contains blue colorant.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Infection Control</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Cover <span class=\"customMeta\" data-dictid=\"f3d6ae0bcd16927772005689a33dba\">transducer</span> and skin with plastic for patients with open wounds or skin issues.</p>\n<p style=\"text-align: center;\">â</p>\n<p style=\"text-align: center;\">Apply <span class=\"customMeta\" data-dictid=\"b0bdc3a1d416927771884d50c944ec\">gel</span> on both sides of the plastic.</p>\n<p style=\"text-align: center;\">â</p>\n<p style=\"text-align: center;\">Clean <span class=\"customMeta\" data-dictid=\"f3d6ae0bcd16927772005689a33dba\">transducer</span> after each use</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following is a common clinical application of dual-energy CT (DECT)? Detection of intracranial hemorrhage B) Differentiation between gout and pseudogout crystals C) Removal of calcium from carotid arteries in head and neck angiography D) Quantification of liver fat in hepatic steatosis E) Reduction of artifacts caused by metal implants F) Characterization of solitary lung nodules", "options": [{"label": "A", "text": "All except A", "correct": false}, {"label": "B", "text": "All except E", "correct": false}, {"label": "C", "text": "All except A and C", "correct": false}, {"label": "D", "text": "All the above", "correct": true}], "correct_answer": "D. All the above", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:697px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Applications of DECT</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Central Nervous System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Removal of <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> from <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> arteries in head and neck <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">angiography</span> <strong>(Option A and C ruled out)</strong><strong> (Option D)</strong></li>\n<li>Detection of <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> <strong>(Option A and C ruled out) </strong><strong> (Option D)</strong></li>\n<li>Elimination of bone structures in CT <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">angiography</span> to enhance <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> imaging</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardiovascular System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Assessment of myocardial <span class=\"customMeta\" data-dictid=\"a8dece102f16927772026b199f06af\">viability</span> and blood flow</li>\n<li>Detection of iron deposits in the myocardium</li>\n<li>Evaluation of <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> stents and calcified plaque</li>\n<li>Identification of aortic endoleaks post-repair</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thoracic System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Evaluation of <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> for diagnosing <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> embolism</li>\n<li>Characterization of <span class=\"customMeta\" data-dictid=\"9729ba172a1692777198c816c4ad9c\">solitary</span> lung nodules by measuring <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">iodine</span> concentration <strong> (Option D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gastrointestinal System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Detection of <span class=\"customMeta\" data-dictid=\"566fcef0991692777184068f36db82\">colonic</span> masses and polyps during CT colonography</li>\n<li>Quantification of liver fat in <span class=\"customMeta\" data-dictid=\"51930ddfeb169277719982af86ec99\">steatosis</span> <strong> (Option D)</strong></li>\n<li>Detection of liver iron accumulation</li>\n<li>Identification of gallstones</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Urinary System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Identification and characterization of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> stones for treatment planning</li>\n<li>Assessment and characterization of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> cysts</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Musculoskeletal System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Differentiation between <span class=\"customMeta\" data-dictid=\"0b216ac0561692777188160d9a8814\">gout</span> and <span class=\"customMeta\" data-dictid=\"866a5797da1692777196eae76838c4\">pseudogout</span> crystals <strong> (Option D)</strong></li>\n<li>Reduction of artifacts caused by metal implants <strong>(Option B ruled out) </strong><strong> (Option D)</strong></li>\n<li>Distinction of <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> from trabecular bone to locate fractures and lesions</li>\n<li>Visualization of tendons and ligaments for better assessment</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which scenario would CECT be preferred over NCCT?", "options": [{"label": "A", "text": "Evaluating a fracture in a long bone", "correct": false}, {"label": "B", "text": "Assessing a lung nodule for malignancy", "correct": true}, {"label": "C", "text": "Diagnosing kidney stones", "correct": false}, {"label": "D", "text": "Evaluating head trauma", "correct": false}], "correct_answer": "B. Assessing a lung nodule for malignancy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/JqyLpEyX5q0vqUWOnaN11743579205.png", "https://image.prepladder.com/notes/KghJgZB8zaR4UqwFosHR1743579272.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Non-Contrast <span class=\"customMeta\" data-dictid=\"44b07c254816927771855a12777513\">Computed Tomography</span> (NCCT) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Contrast-Enhanced <span class=\"customMeta\" data-dictid=\"44b07c254816927771855a12777513\">Computed Tomography</span> (CECT)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NCCT refers to CT <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> performed without the use of <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> contrast agents.</p>\n<p><img alt=\"NCCT\" data-author=\"\" data-hash=\"6256\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/JqyLpEyX5q0vqUWOnaN11743579205.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CECT involves the administration of an <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> <span class=\"customMeta\" data-dictid=\"dbe88a287916927771845c7b3aa937\">contrast agent</span> to enhance the visibility of <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> structures and improve <span class=\"customMeta\" data-dictid=\"55a682d72e16927771865bb4855ba3\">differentiation</span> of tissues in the body.</p>\n<p><img alt=\"RA916\" data-author=\"\" data-hash=\"6257\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/KghJgZB8zaR4UqwFosHR1743579272.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong>:</p>\n<ul>\n<li><strong>Bone Injuries:</strong> Fractures, especially of the spine and long bones. <strong>(Option A ruled out)</strong></li>\n<li><strong>Kidney Stones:</strong> Evaluation of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"eae898f16d1692777183cc3469a664\">calculi</span> (stones) and <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> obstruction. <strong>(Option C ruled out)</strong></li>\n<li><strong>Head Trauma:</strong> Detecting <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> or skull fractures.<strong> (Option D ruled out)</strong></li>\n<li><strong>Acute Abdomen:</strong> Initial evaluation of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain (appendicitis, diverticulitis).</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications:</strong></p>\n<ul>\n<li><strong>Tumor Detection:</strong> Identifying and characterizing masses or tumors in various organs.</li>\n<li><strong>Pulmonary Diseases:</strong> Assessing lung <span class=\"customMeta\" data-dictid=\"54e0888a6616927771945a99208287\">pathology</span> (pneumonia, lung nodules). <strong>(Option B)</strong></li>\n<li><strong>Vascular Assessment:</strong> Evaluating blood vessels for stenosis, thrombosis, or aneurysms.</li>\n<li><strong>Infection</strong>: Assessing abscesses or <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> conditions where contrast can delineate structures.</li>\n<li><strong>Staging of Cancer: </strong>Determining the extent of malignancies by evaluating <span class=\"customMeta\" data-dictid=\"4df97a6cbf169277719172fd1af767\">lymph</span> nodes and distant metastases.</li>\n<li><strong>Assessment of Organ Perfusion</strong>: Evaluating <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> in organs.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Advantages</strong>:</p>\n<ul>\n<li><strong>No Allergic Reactions: </strong>Eliminates the risk of allergic reactions to contrast agents.</li>\n<li><strong>No Need for <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Function Assessment: </strong>Suitable for patients with <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> who cannot tolerate contrast.</li>\n<li><strong>Faster</strong>: Typically quicker to perform than CECT, as no time is needed for contrast administration.</li>\n<li><strong>Cost-effective: </strong>Generally less expensive than CECT.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Advantages:</strong></p>\n<ul>\n<li><strong>Enhanced Visualization</strong>: Improves the contrast between different tissues, making it easier to identify abnormalities.</li>\n<li><strong>Better Soft Tissue Detail: </strong>Provides superior detail of soft tissue structures compared to NCCT.</li>\n<li><strong>Vascular Imaging:</strong> Excellent for visualizing blood vessels and detecting <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> pathologies.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Limitations:</strong></p>\n<ul>\n<li><strong>Limited <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">Diagnostic</span> Capability:</strong> May not provide enough detail for soft tissue structures or <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> assessments.</li>\n<li><strong>Less Sensitivity:</strong> Lower sensitivity for detecting certain conditions, such as tumors or <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> abnormalities, compared to CECT.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Limitations:</strong></p>\n<ul>\n<li><strong>Risk of Allergic Reactions:</strong> Possible allergic reactions to contrast agents, ranging from mild to severe (anaphylaxis).</li>\n<li><strong>Renal Impairment: </strong>Requires caution in patients with pre-existing <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease, as contrast can further compromise <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> function (risk of Contrast-Induced Nephropathy).</li>\n<li><strong>Increased Radiation Exposure:</strong> Slightly higher radiation exposure compared to NCCT due to additional <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> phases.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male patient presents with a 6-month history of progressive shortness of breath and a dry cough. He is a former smoker, having quit 10 years ago, and has no significant past medical history. On examination, he has clubbing of the fingers and fine crackles on lung auscultation. Pulmonary function tests reveal a restrictive pattern with reduced lung volumes and a decreased diffusion capacity.Which imaging modality is most appropriate for confirming the diagnosis of this condition?", "options": [{"label": "A", "text": "Contrast-Enhanced Computed Tomography (CECT) of the chest", "correct": false}, {"label": "B", "text": "High-Resolution CT (HRCT) of the chest", "correct": true}, {"label": "C", "text": "MRI of the chest", "correct": false}, {"label": "D", "text": "Chest X-ray", "correct": false}], "correct_answer": "B. High-Resolution CT (HRCT) of the chest", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/iLs5dybxhZSSjzRWK4ks1743579098.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Specialized <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> technique that provides highly detailed cross-sectional images of the body's internal structures, primarily the lungs</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Technique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Thin Collimation: </strong>Uses thin slices (usually 1 mm or less) to improve image resolution.</li>\n<li><strong>High <span class=\"customMeta\" data-dictid=\"6495ef882b169277719896942b51c3\">Spatial</span> Resolution: </strong>Optimized <span class=\"customMeta\" data-dictid=\"c497b556951692777198b599e4ba86\">scanning</span> protocols to enhance the detail of structures.</li>\n<li><strong>Breath-Holding: </strong>Images are often obtained during full inspiration to reduce motion artifacts.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Pulmonary Assessment:</strong> Primarily used to evaluate lung diseases, especially <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> lung diseases (e.g., <span class=\"customMeta\" data-dictid=\"4acddc3cf5169277718996440e2e14\">Idiopathic</span> <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> Fibrosis, sarcoidosis).</li>\n<li><strong>Tumor Evaluation:</strong> Assessing lung nodules and tumors. (For Pancoast tumor <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> is preferred)</li>\n<li><strong>Infectious Diseases</strong>: Identifying lung infections (pneumonia, tuberculosis).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Reticular Patterns: </strong>Suggestive of <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> and <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> lung disease.</li>\n<li><strong>Ground-Glass Opacities: </strong>Indicate <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> or partial consolidation.</li>\n<li><strong>Nodules and Masses: </strong>Detailed <span class=\"customMeta\" data-dictid=\"33ba8d60fb16927772029d1067e602\">visualization</span> of <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> nodules.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Advantages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>High Sensitivity and Specificity:</strong> Superior ability to detect and characterize lung pathologies compared to standard CT or X-rays.</li>\n<li><strong>Detailed Assessment:</strong> Provides detailed <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> information, aiding in accurate diagnosis and treatment planning.</li>\n<li><strong>3D Reconstruction: </strong>Data can be processed to create 3D images for better <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> visualization.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Limitations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Radiation Exposure: </strong>Increased radiation dose compared to conventional radiography.</li>\n<li><strong>Cost</strong>: Generally more expensive than standard <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> modalities.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Arrange the following in their decreasing order of penetration power 1) Neutrons 2) Alpha (Îą) rays 3) Beta (β) rays 4) Gamma (Îł) rays", "options": [{"label": "A", "text": "1&amp;gt;2&amp;gt;3&amp;gt;4", "correct": false}, {"label": "B", "text": "1&amp;gt;4&amp;gt;3&amp;gt;2", "correct": true}, {"label": "C", "text": "4&amp;gt;3&amp;gt;2&amp;gt;1", "correct": false}, {"label": "D", "text": "2&amp;gt;3&amp;gt;4&amp;gt;1", "correct": false}], "correct_answer": "B. 1&gt;4&gt;3&gt;2", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alpha (Îą) rays: </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Particles emitted by the <span class=\"customMeta\" data-dictid=\"ff628904401692777193c8a9f9159e\">nucleus</span> through Îą decay, containing 2 protons and 2 neutrons.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Beta (β) rays:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Particles emitted by the <span class=\"customMeta\" data-dictid=\"ff628904401692777193c8a9f9159e\">nucleus</span> through β decay, either electrons/positrons</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gamma (Îł) rays:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Photons emitted by the nucleus.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ionizing power: </strong>(damaging capacity of <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">linear</span> energy transfer - LET)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alpha (Îą) &gt; <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">Beta</span> (β) &gt; <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-Rays</span> &gt; <span class=\"customMeta\" data-dictid=\"49be0416121692777188dc8944b7bc\">Gamma</span> (Îł) rays</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Penetration power:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neutrons &gt; <span class=\"customMeta\" data-dictid=\"49be0416121692777188dc8944b7bc\">Gamma</span> (Îł)rays &gt;Beta (β)rays &gt;Alpha (Îą)rays</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mTgT1jO1d5lEfX77dt831748954732.mp3", "video": ""}, {"text": "Which window setting would be most appropriate for viewing bone structures in a CT scan?", "options": [{"label": "A", "text": "Low window level and narrow window width", "correct": false}, {"label": "B", "text": "High window level and wide window width", "correct": true}, {"label": "C", "text": "Low window level and wide window width", "correct": false}, {"label": "D", "text": "High window level and narrow window width", "correct": false}], "correct_answer": "B. High window level and wide window width", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old man presents with sudden headache, confusion, and decreased consciousness following recent cranial surgery. CT image is given below. What is the black area seen in the CT?", "options": [{"label": "A", "text": "Blood", "correct": false}, {"label": "B", "text": "Air", "correct": true}, {"label": "C", "text": "Pus", "correct": false}, {"label": "D", "text": "Highly vascularised areas", "correct": false}], "correct_answer": "B. Air", "question_images": ["https://image.prepladder.com/notes/AY68USr9aRjGopMrOvGJ1743578424.png"], "explanation_images": ["https://image.prepladder.com/notes/DFAeKEYdtydtK9lhsFRD1743578514.png", "https://image.prepladder.com/notes/xcJHtzjKcpuFmK11rXHc1743578646.png"], "explanation": "<table>\n<thead>\n<tr>\n<th><strong>X-ray Appearance</strong></th>\n<th><strong>Cause</strong></th>\n<th><strong>Examples</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td><strong>Black</strong></td>\n<td>X-rays <strong>pass through less dense tissues</strong> and reach the <span class=\"customMeta\" data-dictid=\"1028b4ebb31692777183bcb9e95ee0\">cassette</span> with <strong>more energy</strong></td>\n<td><strong>Air or gas</strong>, e.g., lungs, <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> gas</td>\n</tr>\n<tr>\n<td><strong>White</strong></td>\n<td>X-rays are <strong>mostly absorbed by very dense tissues</strong>, so little reaches the cassette</td>\n<td><strong>Bone</strong>, <strong>metal</strong>, <strong>calcified areas</strong></td>\n</tr>\n<tr>\n<td><strong>Gray</strong></td>\n<td>X-rays pass through <strong>intermediate-density tissues</strong></td>\n<td><strong>Soft tissues</strong>, <strong>muscles</strong>, <strong>fat</strong>, <strong>organs</strong></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following items with its corresponding Hounsfield Unit Item Hounsfield Unit 1.Metal a.1000 2.Bone b.3000 3.Air c.-1000 4. Water d. 0", "options": [{"label": "A", "text": "1b,2a,3c,4d", "correct": true}, {"label": "B", "text": "1a,2b,3d,4c", "correct": false}, {"label": "C", "text": "1c,2d,3a,4b", "correct": false}, {"label": "D", "text": "1d,2c,3b,4a", "correct": false}], "correct_answer": "A. 1b,2a,3c,4d", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:418px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Item</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hounsfield Unit (HU)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Water</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0 HU</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Air</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-1000 HU</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1000 HU</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dense bones like the cochlea</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2000 HU</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metals</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3000 HU</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is NOT true about Computed Tomography?", "options": [{"label": "A", "text": "Uses a rotating beam of X-ray", "correct": false}, {"label": "B", "text": "Uses more radiation than a plain X-ray", "correct": false}, {"label": "C", "text": "The computer generates the images", "correct": false}, {"label": "D", "text": "Slices are as if viewing from the head end of the bed", "correct": true}], "correct_answer": "D. Slices are as if viewing from the head end of the bed", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/lnKtfhpEYXTzV1iufUmY1743578285.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is false?", "options": [{"label": "A", "text": "C-arm is a mobile X-ray machine", "correct": false}, {"label": "B", "text": "Fluoroscopy shows continuous X-ray images in a monitor", "correct": false}, {"label": "C", "text": "In fluoroscopy, only movement of a body part can be visualized", "correct": true}, {"label": "D", "text": "Fluoroscopy can be used in catheter insertion", "correct": false}], "correct_answer": "C. In fluoroscopy, only movement of a body part can be visualized", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/UXclYHWfzfwmaMiJQgls1743578077.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is false about mammography?", "options": [{"label": "A", "text": "Grids are used to reduce scattered radiation", "correct": false}, {"label": "B", "text": "Primarily for women over 40", "correct": false}, {"label": "C", "text": "Breast compression is required", "correct": false}, {"label": "D", "text": "The craniocaudal view will show the breast with the axillary tail", "correct": true}], "correct_answer": "D. The craniocaudal view will show the breast with the axillary tail", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/e7tSbgXoWpqPlEqJkK1V1743577835.png", "https://image.prepladder.com/notes/WmyJMygcwWf8MeJMsPx71743577913.png", "https://image.prepladder.com/notes/olKiWok48xf5f4K9nzTj1743577950.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following types of X-rays with its mechanism 1. Film X-ray a. X-rays hit a detector which converts them into an electrical charge 2. Computed Radiography b. X-rays strike a plate that absorbs the energy and stores it at a specific location 3. Digital Radiography c. X-rays strike a fluorescent screen, producing light", "options": [{"label": "A", "text": "1a,2b,3c", "correct": false}, {"label": "B", "text": "1c,2b,3a", "correct": true}, {"label": "C", "text": "1b,2a,3c", "correct": false}, {"label": "D", "text": "1b,2c,3a", "correct": false}], "correct_answer": "B. 1c,2b,3a", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/4Bd8Q8xTODUKr0oKAwLZ1743577690.png", "https://image.prepladder.com/notes/4Bd8Q8xTODUKr0oKAwLZ1743577690.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type of <span class=\"customMeta\" data-dictid=\"fd0c8ab494169277720227102dc79a\">X-ray</span> System</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Description</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Film/Screen Combination</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-<strong> <span class=\"customMeta\" data-dictid=\"fd0c8ab494169277720227102dc79a\">X-ray</span> beam strikes a <span class=\"customMeta\" data-dictid=\"df068e6efc16927772029693b5023e\">fluorescent</span> screen, producing light.</strong></p>\n<p>- The light exposes a film, which is then developed.</p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Computed <span class=\"customMeta\" data-dictid=\"180f4b674c169277719778e96a53ca\">Radiography</span> (CR)</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-<strong> <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-rays</span> strike a plate that absorbs the energy and stores it at a specific location.</strong></p>\n<p>- A laser scans the plate, releasing light from the location, which is then detected and stored in a computer.</p>\n<br/>\n<img alt=\"RA905\" data-author=\"\" data-hash=\"6246\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/4Bd8Q8xTODUKr0oKAwLZ1743577690.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Digital <span class=\"customMeta\" data-dictid=\"180f4b674c169277719778e96a53ca\">Radiography</span> (DR)</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-<strong> <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-rays</span> hit a detector, which converts them into light or an electrical charge immediately.</strong></p>\n<p>- The image is stored directly in a computer.</p>\n<img alt=\"RA905\" data-author=\"\" data-hash=\"6246\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/4Bd8Q8xTODUKr0oKAwLZ1743577690.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "True about Compton effect in X-rays are 1) Interacts with the innermost electron 2) Interacts with the outermost electron 3) Responsible for contrast on the films 4) Produces scattered radiations on the films", "options": [{"label": "A", "text": "1,3", "correct": false}, {"label": "B", "text": "2,3", "correct": false}, {"label": "C", "text": "1,4", "correct": false}, {"label": "D", "text": "2,4", "correct": true}], "correct_answer": "D. 2,4", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/OPdWvkyTDG5D9pMLSY3h1743577495.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Compton effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Photoelectric effect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Interaction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Outermost <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> (Statement-2)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Innermost <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> (Statement-1)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Process</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Displaces the outer <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span>  and a <strong>high energy photon</strong> is emitted</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Displaces the innermost <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> and a <strong>low energy photon</strong> is emitted</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Result</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Scattered radiations</strong> on the film - <strong>obscures the image (Statement-4)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Responsible for <strong>Contrast</strong> in the film - <strong>Good (provides a good image) (Statement-4)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Relation to atomic number</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Independent of atomic number</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Directly proportional to atomic number</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following statements is true regarding the machine shown below", "options": [{"label": "A", "text": "Produced by sudden deceleration of moving electrons", "correct": true}, {"label": "B", "text": "Anode is primarily made up of Lead (Pb)", "correct": false}, {"label": "C", "text": "The majority of heat dissipation is by convection", "correct": false}, {"label": "D", "text": "Electron beam travels from anode to the cathode", "correct": false}], "correct_answer": "A. Produced by sudden deceleration of moving electrons", "question_images": ["https://image.prepladder.com/notes/2pYAB0erRNrLOnuALpeW1743577193.png"], "explanation_images": ["https://image.prepladder.com/notes/2pYAB0erRNrLOnuALpeW1743577193.png", "https://image.prepladder.com/notes/BnwTIkD29SHht5TA6EA91743577295.png", "https://image.prepladder.com/notes/bgw9XpwsAJTlqhuaKvMR1743577370.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Introduction</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Discovered by <strong>W.C. <span class=\"customMeta\" data-dictid=\"7b9ed7cc8f16927771973e5430a32f\">Roentgen</span> on 8 November 1895</strong> (International Day of Radiology).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Production</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>By <strong>sudden <span class=\"customMeta\" data-dictid=\"7be129d4bb1692777185fa5706fe88\">deceleration</span> of fast-moving <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> beam</strong><strong> (Option A)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Working principle</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"98f339c57716927771836df0bff47a\">Cathode</span> (filament) is an <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> source that produces the <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> beam and the <span class=\"customMeta\" data-dictid=\"a7fbef62b91692777181bfe2d1b741\">Anode</span> is a <span class=\"customMeta\" data-dictid=\"40067257821692777201a208cbed9c\">tungsten</span> target for the <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> beam.</li>\n<li>The <strong>electron beam travels from the <span class=\"customMeta\" data-dictid=\"98f339c57716927771836df0bff47a\">cathode</span> (negatively charged) to the <span class=\"customMeta\" data-dictid=\"a7fbef62b91692777181bfe2d1b741\">anode</span> (positively charged)</strong> <strong>(Option D)</strong></li>\n<li>Thermionic emission occurs at the Cathode.</li>\n<li>Blocking of the <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> beam is done at the Anode, where <strong>99% of heat dissipation is by Radiation </strong><strong>(Option C)</strong> and the remaining 1% escapes through the window onto a film called X-rays.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Components</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>The Cathode</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Made up of <strong>Tungsten (atomic no.- 74) &amp; Thorium</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>The Anode</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Made up of<strong> <span class=\"customMeta\" data-dictid=\"40067257821692777201a208cbed9c\">Tungsten</span> &amp; Rhenium</strong> <strong>(Option B)</strong>.</li>\n<li>Rotatory anodes are preferred (to avoid <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> points), now <span class=\"customMeta\" data-dictid=\"9cf5375557169277719946c3651430\">stationary</span> anodes are only used in Portable <span class=\"customMeta\" data-dictid=\"fd0c8ab494169277720227102dc79a\">X-ray</span> machines.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glass envelope</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Made up of Lead (Pb).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Focusing cup</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Made up of Nickel.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following are examples of ionizing radiation? 1) X-rays 2) UV rays 3) MRI 4) SPECT 5) Doppler 6) IVP (Intravenous pyelography)", "options": [{"label": "A", "text": "1,3,5,6", "correct": false}, {"label": "B", "text": "1,2,4,6", "correct": false}, {"label": "C", "text": "1,4,6", "correct": true}, {"label": "D", "text": "1,2,4", "correct": false}], "correct_answer": "C. 1,4,6", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ionizing radiation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-ionizing radiation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rays that have the ability to displace orbiting electrons from the <span class=\"customMeta\" data-dictid=\"435060133416927771829458eecc80\">atom</span> thus causing biomolecular damage.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Some <span class=\"customMeta\" data-dictid=\"c67401aedd169277718703fb7bc5ed\">electromagnetic</span> and mechanical waves do not dissipate energy and hence are called non-ionizing.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Conventional X-rays</strong>, Mammography, CT</li>\n<li><strong>Contrast X-rays:</strong> HSG, IVP, ERCP, Myelography</li>\n<li><strong>Nuclear <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> (gamma rays):</strong> PET, SPECT, Scintigraphy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>UV rays</strong></li>\n<li><strong>USG</strong> (including Doppler, FAST)</li>\n<li><strong>MRI</strong> (Magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">resonance</span> imaging), MRCP</li>\n<li>Thermography</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Regarding X-rays in comparison to Gamma (Îł) rays, that X-rays have all among the following except", "options": [{"label": "A", "text": "Less penetration power", "correct": false}, {"label": "B", "text": "Emits a higher wavelength light", "correct": false}, {"label": "C", "text": "Relative lower frequency", "correct": false}, {"label": "D", "text": "Emitted from within the nucleus", "correct": true}], "correct_answer": "D. Emitted from within the nucleus", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/nUHjxtdGVumDxTQdr6Nd1743577087.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:384px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-rays </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gamma (Îł) rays</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Energy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Frequency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Penetration power</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Wavelength</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Origin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extranuclear</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nucleus</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 35 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following statements is false regarding acute radiation syndrome?", "options": [{"label": "A", "text": "Gl manifestations occur at a lower radiation dose than bone marrow depression", "correct": true}, {"label": "B", "text": "Doses greater than 2 Gy cause hematopoietic syndrome with pancytopenia", "correct": false}, {"label": "C", "text": "Doses greater than 6 Gy cause GI syndrome with dehydration", "correct": false}, {"label": "D", "text": "Doses greater than 20 -30 Gy cause Cardiovascular syndrome", "correct": false}], "correct_answer": "A. Gl manifestations occur at a lower radiation dose than bone marrow depression", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Radiation Dose (Gy)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hematopoietic Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;2 Gy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pancytopenia, infections, bleeding, anemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gastrointestinal Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;6 Gy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea, vomiting, dehydration, diarrhea, shock</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardiovascular/CNS Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;30 Gy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypotension, seizures, coma, <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> collapse</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Empty thecal sac sign on MRI is seen in:", "options": [{"label": "A", "text": "Arachnoiditis", "correct": true}, {"label": "B", "text": "Discitis", "correct": false}, {"label": "C", "text": "Vertebral osteomyelitis", "correct": false}, {"label": "D", "text": "Tethered cord syndrome", "correct": false}], "correct_answer": "A. Arachnoiditis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not included in Rigler's triad, as observed in a middle-aged female patient with a past medical history of cholelithiasis, who presented with symptoms of vomiting and abdominal pain, and whose abdominal radiograph revealed Rigler's triad?", "options": [{"label": "A", "text": "Pneumobilia", "correct": false}, {"label": "B", "text": "Small bowel obstruction", "correct": false}, {"label": "C", "text": "Ectopic gallstone", "correct": false}, {"label": "D", "text": "Large bowel obstruction", "correct": true}], "correct_answer": "D. Large bowel obstruction", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D. \n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What investigation is depicted in the radiograph among the following options?", "options": [{"label": "A", "text": "Barium swallow", "correct": false}, {"label": "B", "text": "Barium meal", "correct": true}, {"label": "C", "text": "Barium meal follow through", "correct": false}, {"label": "D", "text": "Barium enema", "correct": false}], "correct_answer": "B. Barium meal", "question_images": ["https://image.prepladder.com/content/6WOzkkwxk1nlONOfCBwL1697542174.png"], "explanation_images": ["https://image.prepladder.com/content/pF4V1xM6nEwO2yEcG6Hs1697542218.png", "https://image.prepladder.com/content/JBR8vlkElHHc4BQIivVs1697542248.png", "https://image.prepladder.com/content/eiyO6dblaP8kCy5uyvRF1697542274.png", "https://image.prepladder.com/content/904XJHzIZ5pIPXZwhdYt1697542293.png", "https://image.prepladder.com/content/z1ar17dqpbPBMHv5FCe21697542315.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the cause of the appearance observed in IVP?", "options": [{"label": "A", "text": "Horseshoe kidney", "correct": false}, {"label": "B", "text": "Ureterococele", "correct": true}, {"label": "C", "text": "Bladder tumor", "correct": false}, {"label": "D", "text": "Posterior urethral valve", "correct": false}], "correct_answer": "B. Ureterococele", "question_images": ["https://image.prepladder.com/content/p3ORuOmrg7Bir083t6yk1697525542.png"], "explanation_images": [], "explanation": "<p>Correct Option b: Ureterococele.\n<table>\n<tbody>\n<tr>\n<td>Definition</td>\n<td>Ureterocele is a <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> or <span class=\"customMeta\" data-dictid=\"0f0b2969921692777180de24f0b0c0\">acquired</span> condition where the <span class=\"customMeta\" data-dictid=\"8cde7563da1692777201fca2b1f090\">ureter</span> (the tube that carries <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> from the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> to the bladder) balloons at its lower end, forming a pouch-like structure.</td>\n</tr>\n<tr>\n<td>Types</td>\n<td>Primary (congenital) and secondary (acquired) ureteroceles. Primary ureteroceles are typically present from birth and occur as a result of <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> embryonic development. Secondary ureteroceles may develop later in life due to various factors.</td>\n</tr>\n<tr>\n<td>Location</td>\n<td>Most commonly found in the <span class=\"customMeta\" data-dictid=\"8cde7563da1692777201fca2b1f090\">ureter</span> that drains one kidney, but <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> ureteroceles (affecting both kidneys) can occur in rare cases.</td>\n</tr>\n<tr>\n<td>Presentation</td>\n<td>Ureteroceles can be <span class=\"customMeta\" data-dictid=\"d1a9a79f701692777182066af09044\">asymptomatic</span> or cause a range of symptoms, including <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections (UTIs), <span class=\"customMeta\" data-dictid=\"316968b3e116927772021379938005\">flank</span> pain, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> discomfort, <span class=\"customMeta\" data-dictid=\"660645b0c91692777188bbdf3fedff\">hematuria</span> (blood in the urine), and difficulty in <span class=\"customMeta\" data-dictid=\"397f16a7a71692777187ffffefa7e6\">emptying</span> the bladder.</td>\n</tr>\n<tr>\n<td>Diagnosis</td>\n<td>Typically diagnosed through <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> studies such as ultrasound, <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> <span class=\"customMeta\" data-dictid=\"b28907b0441692777196ab31880644\">pyelogram</span> (IVP), CT scan, or cystoscopy.</td>\n</tr>\n<tr>\n<td>Treatment</td>\n<td>Treatment depends on the severity of symptoms and complications. Options may include antibiotics for UTIs, <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> removal of the ureterocele, <span class=\"customMeta\" data-dictid=\"35ca8c2d5f16927771879351e8f97e\">endoscopic</span> procedures, and in some cases, surgery to reconstruct the <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> tract.</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Personal monitoring of radiation is done by:", "options": [{"label": "A", "text": "TLD badge", "correct": true}, {"label": "B", "text": "Collimators", "correct": false}, {"label": "C", "text": "Linear accelerator", "correct": false}, {"label": "D", "text": "Grid", "correct": false}], "correct_answer": "A. TLD badge", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/UIHtqRfvTST9OU8wI0lT1746516360.png", "https://image.prepladder.com/content/SRxtUkPsFMCMmPzF9ruQ1746516360.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:691px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>TLD (Thermoluminescent Dosimeter) Badge</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Purpose </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It is worn by individuals in radiation-exposed environments, such as medical <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> or nuclear facilities, to track their radiation dose and ensure it stays within safe limits.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Location </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Worn<strong> beneath </strong>the lead apron (as lead apron cuts off some radiation)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Duration </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>According to the <span class=\"customMeta\" data-dictid=\"d07ff57c3f1692777182594c5f75ba\">Atomic Energy</span> Regulatory Board (AERB) of India, TLD badges are generally replaced and analyzed <strong>every 3 months</strong> to assess <span class=\"customMeta\" data-dictid=\"fa914a0d95169277718542753b513d\">cumulative</span> radiation exposure.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Composition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Thermoluminescent phosphor crystals</strong>:</p>\n<ul>\n<li>Calcium <span class=\"customMeta\" data-dictid=\"535af9a2181692777199309af44d24\">sulfate</span> dysprosium</li>\n<li>Lithium fluoride</li>\n<li>Lithium borate</li>\n<li>Berrylium oxide</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Principle </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"600\" src=\"https://image.prepladder.com/content/UIHtqRfvTST9OU8wI0lT1746516360.png\" width=\"557\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following is most radiosensitive?", "options": [{"label": "A", "text": "Testis", "correct": true}, {"label": "B", "text": "Bone", "correct": false}, {"label": "C", "text": "Nerve", "correct": false}, {"label": "D", "text": "Muscle", "correct": false}], "correct_answer": "A. Testis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/itqLZPe9jjsIlqFzF6sA1747656354.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What type of MRI image is given below?", "options": [{"label": "A", "text": "Proton density image", "correct": false}, {"label": "B", "text": "Susceptibility weighted image", "correct": true}, {"label": "C", "text": "Gradient echo image", "correct": false}, {"label": "D", "text": "Inversion recovery image", "correct": false}], "correct_answer": "B. Susceptibility weighted image", "question_images": ["https://image.prepladder.com/content/VG4WCpVPuPnhKAb4tWEe1745573472.png"], "explanation_images": ["https://image.prepladder.com/content/6Marx1hxvOHmhjU1TCPy1745573544.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the imaging modality given below.", "options": [{"label": "A", "text": "USG", "correct": true}, {"label": "B", "text": "Fluoroscopy", "correct": false}, {"label": "C", "text": "X-Ray", "correct": false}, {"label": "D", "text": "MRI", "correct": false}], "correct_answer": "A. USG", "question_images": ["https://image.prepladder.com/notes/D1BTqyRGpzeDKN9NbM3c1747112157.png"], "explanation_images": ["https://image.prepladder.com/notes/j1MXLBLA0ywFZQ1AHkl11747112214.png", "https://image.prepladder.com/notes/jN9Rel6U1rcyhvXlQ9Ef1746437989.png", "https://image.prepladder.com/notes/C2ttVItYYYOLn9RXXqcb1746438029.png", "https://image.prepladder.com/notes/2FiCAwGEAGrzI5tpcWkb1746438059.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ultrasound Gel</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose of Gel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Eliminates air pockets between <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> and skin</strong><strong> </strong>for <strong>effective </strong>sound transmission.</li>\n<li>Serves as a medium for sound and lubricant.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Preferred Gel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Hydrogel </strong>is preferred over Lipogel for easier cleaning.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ingredients</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Distilled water, carbomer, <span class=\"customMeta\" data-dictid=\"7f4fb60ca816927771876ae5f619eb\">ethylenediaminetetraacetic acid</span> (EDTA), <span class=\"customMeta\" data-dictid=\"e2c0074e9c1692777196b2028a4274\">propylene</span> glycol, glycerin, trolamine, and occasionally contains blue colorant.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Infection Control</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cover <span class=\"customMeta\" data-dictid=\"f3d6ae0bcd16927772005689a33dba\">transducer</span> and skin with plastic for patients with open wounds or skin issues.</p>\n<p>â</p>\n<p>Apply <span class=\"customMeta\" data-dictid=\"b0bdc3a1d416927771884d50c944ec\">gel</span> on both sides of the plastic.</p>\n<p>â</p>\n<p>Clean <span class=\"customMeta\" data-dictid=\"f3d6ae0bcd16927772005689a33dba\">transducer</span> after each use</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:582px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Types of <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">Ultrasound</span> Transducers/ Probes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Linear</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Shape: Rectangular/parallelogram image</li>\n<li>Use:<strong> Vascular, high-resolution imaging</strong></li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Radiology\" data-author=\"NA\" data-hash=\"11865\" data-license=\"NA\" data-source=\"NA\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/jN9Rel6U1rcyhvXlQ9Ef1746437989.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Convex</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Shape: Sector image, curved top</li>\n<li>Use: <strong>Abdominal, OBS/ GYN</strong></li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Radiology\" data-author=\"NA\" data-hash=\"11866\" data-license=\"NA\" data-source=\"NA\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/C2ttVItYYYOLn9RXXqcb1746438029.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phased Array</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Shape: Sector image, pointed top</li>\n<li>Use: <strong>Cardiac (fits between ribs), endocavitary (like endovaginal), <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> brain</strong></li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Radiology\" data-author=\"NA\" data-hash=\"11867\" data-license=\"NA\" data-source=\"NA\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/2FiCAwGEAGrzI5tpcWkb1746438059.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vector/ Trapezoidal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Shape: Trapezoidal image</li>\n<li>Use: <strong>Abdominal, cardiac, Doppler</strong></li>\n<li>Features: Hybrid of <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">linear</span> &amp; phased</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The magnetic field in MRI machines is measured in which of the following units?", "options": [{"label": "A", "text": "Tesla", "correct": true}, {"label": "B", "text": "HU", "correct": false}, {"label": "C", "text": "KHz", "correct": false}, {"label": "D", "text": "Hg", "correct": false}], "correct_answer": "A. Tesla", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Unit</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Symbol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Measurement Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Application</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tesla</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>T</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Magnetic field strength</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used in <strong>MRI</strong> to measure <span class=\"customMeta\" data-dictid=\"c731b7ca621692777191324e5d32e7\">magnetic field</span> intensity (e.g., 1.5T, 3T, 7T <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> scanners)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Gauss</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>G</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Magnetic field strength</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Older unit for <span class=\"customMeta\" data-dictid=\"c731b7ca621692777191324e5d32e7\">magnetic field</span> strength (1T = 10,000G)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Gray</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Gy</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Absorbed dose of radiation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Measures energy absorbed per unit mass in <strong>radiotherapy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Sievert</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sv</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Biological effect of radiation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used in <strong>radiation safety</strong> to assess exposure risk</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hounsfield Unit</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>HU</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Tissue density in CT</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used in <strong>CT scans</strong> to <span class=\"customMeta\" data-dictid=\"c9001edbf216927771860f3475b44c\">differentiate</span> tissues (e.g., bone = +1000 HU, air = -1000 HU)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Becquerel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bq</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Radioactive <span class=\"customMeta\" data-dictid=\"6a867651ba1692777185bb15ba2f9c\">decay</span> rate</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used in <strong>nuclear medicine</strong> to measure radioactivity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Curie</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ci</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Radioactivity</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Older unit (1 Ci = 3.7 Ă 10šⰠBq), used in <strong>nuclear imaging</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Roentgen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>R</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ionization in air</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used in older radiation exposure measurements</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Millisievert</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>mSv</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Radiation dose</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used for <strong>radiation protection</strong>, <span class=\"customMeta\" data-dictid=\"871577be5e169277718596f7614659\">CT scan</span> doses are often measured in mSv</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Electron Volt</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>eV</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Energy of X-rays/Gamma rays</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used in <strong>radiation physics</strong> to measure <span class=\"customMeta\" data-dictid=\"8da14408b216927771952175d1d0b0\">photon</span> energy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Kiloelectron Volt</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>keV</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>X-ray <span class=\"customMeta\" data-dictid=\"8da14408b216927771952175d1d0b0\">photon</span> energy</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Important in <strong>X-ray and CT imaging</strong> for beam quality</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not included in the whole-body CT scan protocol for a trauma patient?", "options": [{"label": "A", "text": "CT Head", "correct": false}, {"label": "B", "text": "CT Cervical spine", "correct": false}, {"label": "C", "text": "CT Limbs", "correct": true}, {"label": "D", "text": "CT Abdomen", "correct": false}], "correct_answer": "C. CT Limbs", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The principle of Linear accelerators is utilized in the production of?", "options": [{"label": "A", "text": "Protons", "correct": false}, {"label": "B", "text": "X-rays", "correct": true}, {"label": "C", "text": "Gamma rays", "correct": false}, {"label": "D", "text": "Neutrons", "correct": false}], "correct_answer": "B. X-rays", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - X\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Ideal thickness of lead aprons to be worn by workers working in radiology department?", "options": [{"label": "A", "text": "0.5mm", "correct": true}, {"label": "B", "text": "1mm", "correct": false}, {"label": "C", "text": "0.75mm", "correct": false}, {"label": "D", "text": "2mm", "correct": false}], "correct_answer": "A. 0.5mm", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/DzEryrKxzl44pOEfupPe1747656526.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is true regarding CT scan?", "options": [{"label": "A", "text": "CT score of water is 0", "correct": true}, {"label": "B", "text": "CT consists of unfiltered X-ray beams", "correct": false}, {"label": "C", "text": "It is the investigation of choice for Gallstones", "correct": false}, {"label": "D", "text": "The typical effective dose for a NCCT head scan is 20mSv", "correct": false}], "correct_answer": "A. CT score of water is 0", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - A &lt;span class=\"customMeta\" data-dictid=\"2d11b2f6fd16927771855ade3589cb\"&gt;CT number&lt;/span&gt; of 0 is assig\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following contrast agents is safe to use in renal failure patients?", "options": [{"label": "A", "text": "Gadolinium", "correct": false}, {"label": "B", "text": "Iodinated ionic contrast", "correct": false}, {"label": "C", "text": "Iodinated non-ionic contrast", "correct": false}, {"label": "D", "text": "USG contrast", "correct": true}], "correct_answer": "D. USG contrast", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - USG\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the best management of aneurysm by interventional radiologist?", "options": [{"label": "A", "text": "Coiling", "correct": true}, {"label": "B", "text": "endothermal ablation", "correct": false}, {"label": "C", "text": "Bare stent placement", "correct": false}, {"label": "D", "text": "Sclerotherapy", "correct": false}], "correct_answer": "A. Coiling", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Coiling\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Ga-68 PSMA PET scan is used to diagnose which of the following conditions?", "options": [{"label": "A", "text": "Lung cancer", "correct": false}, {"label": "B", "text": "Prostate cancer", "correct": true}, {"label": "C", "text": "Colon cancer", "correct": false}, {"label": "D", "text": "Liver cancer", "correct": false}], "correct_answer": "B. Prostate cancer", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "During the procedure shown below which one of the following substances is uptaken by the cancer cells?", "options": [{"label": "A", "text": "Alanine", "correct": false}, {"label": "B", "text": "Glucose", "correct": true}, {"label": "C", "text": "Sodium", "correct": false}, {"label": "D", "text": "Calcium", "correct": false}], "correct_answer": "B. Glucose", "question_images": ["https://image.prepladder.com/content/brFxTrcgMp5FD8kWqSVz1747381884.png"], "explanation_images": ["https://image.prepladder.com/content/T30rrzO0XjhWoCIW6zts1747381894.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Aerobic Glycolysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cancer cells rely heavily on glycolysis, increasing <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> and 18F-FDG uptake, even with oxygen.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Transport &amp; Trapping</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>GLUT-1 transporters mediate <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> entry. 18F-FDG is phosphorylated and trapped inside cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tumor Heterogeneity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Differences in tumor subtype, size, and <span class=\"customMeta\" data-dictid=\"3728deb0881692777192af3b093774\">microvasculature</span> affect 18F-FDG uptake.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Implication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Prognostic Indicator</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Higher 18F-FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> correlates with <strong>worse prognosis</strong> (e.g., shorter DFS in <span class=\"customMeta\" data-dictid=\"1c5272ad3d1692777190e71409d07a\">invasive</span> ductal carcinoma).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Reverse Warburg Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cancer-associated fibroblasts (CAFs) increase <span class=\"customMeta\" data-dictid=\"185a500ee91692777188b3044db06d\">glycolysis</span> in tumor cells via <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> coupling.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment Monitoring</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>PET <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> tracks changes in 18F-FDG uptake, reflecting <strong>therapy responses</strong> <span class=\"customMeta\" data-dictid=\"e4865847fa169277720044d7b530b0\">targeting</span> <span class=\"customMeta\" data-dictid=\"185a500ee91692777188b3044db06d\">glycolysis</span> or mitochondria.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old female patient presents with complaints of abdominal pain; further investigations show elevated PTH levels and renal calculi. Which of the following investigations should be done next?", "options": [{"label": "A", "text": "USG thyroid", "correct": false}, {"label": "B", "text": "TC 99m sestamibi scan", "correct": true}, {"label": "C", "text": "Dexa scan", "correct": false}, {"label": "D", "text": "Radioactive iodine uptake test", "correct": false}], "correct_answer": "B. TC 99m sestamibi scan", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/5pZycAVR3rFl9qv1Ldk41747381984.png", "https://image.prepladder.com/content/vpfqXgmNvzn16Ruu6J9D1747381998.png", "https://image.prepladder.com/content/MbMXZRFLitQkI3HObMxe1747382005.png", "https://image.prepladder.com/content/x6V5VIxeaRlGoX8lBLrV1747382013.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Hyperparathyroidism</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Functions of the <span class=\"customMeta\" data-dictid=\"3bcd005ca116927771941ae5bca4a8\">parathyroid</span> gland</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Increase the level of <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> in the body (Subperiosteal bone resorption).</li>\n<li>Decrease the level of <span class=\"customMeta\" data-dictid=\"bfea0730ac16927771959eb551740f\">phosphorus</span> in the body (Urinary <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of phosphorus).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Types </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Primary hyperparathyroidism</strong> (parathyroid <span class=\"customMeta\" data-dictid=\"c3c9726266169277718021f4f0fa16\">adenoma</span> and <span class=\"customMeta\" data-dictid=\"3bcd005ca116927771941ae5bca4a8\">parathyroid</span> hyperplasia)</li>\n<li><strong>Secondary hyperparathyroidism</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Radiological features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Subperiosteal resorption</strong> usually starts in the middle <span class=\"customMeta\" data-dictid=\"e9451cd23d1692777195fe471f486e\">phalanx</span> of the index finger's <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> side, leading to a <span class=\"customMeta\" data-dictid=\"5725f054721692777184f74b5fa780\">concavity</span> of bone<strong> (the earliest bone change).</strong></li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Bennett, Jackson &amp; Suliburk, James &amp; MorĂłn, Fanny.\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Subperiosteal-resorption-of-the-radial-aspect-of-the-middle-phalanges-of-the-second-and_fig1_339432582\" data-tags=\"\" height=\"388\" src=\"https://image.prepladder.com/content/5pZycAVR3rFl9qv1Ldk41747381984.png\" width=\"350\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>The \"salt and pepper\" appearance, or pepper pot skull</strong> (lytic lesions in the skull).</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Dra. MarĂa Ferretti Diez\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/salt-and-pepper-skull#image-51937521 \" data-tags=\"\" height=\"282\" src=\"https://image.prepladder.com/content/vpfqXgmNvzn16Ruu6J9D1747381998.png\" width=\"350\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>Brown tumor or <span class=\"customMeta\" data-dictid=\"dc4ced4b86169277719422ad2689a5\">osteitis</span> fibrosa cystica:</strong> <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">Cystic</span> lesions resulting from excessive <span class=\"customMeta\" data-dictid=\"fc8c28347a16927771945680bd00be\">osteoclastic</span> <span class=\"customMeta\" data-dictid=\"797daba8ca1692777197dc9f8d3a4a\">resorption</span> appear as low-density, multiloculated cysts that can cause bone expansion, often accompanied by <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> and <span class=\"customMeta\" data-dictid=\"09e414c5a71692777188ef029aefe5\">granulation</span> tissue (more common in primary hyperparathyroidism).</li>\n</ul>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Frank Gaillard \" data-hash=\"\" data-license=\"CC BY-SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Osteitis_fibrosa_cystica#/media/File:Brown_tumours_of_the_hands.jpg\" data-tags=\"\" height=\"315\" src=\"https://image.prepladder.com/content/MbMXZRFLitQkI3HObMxe1747382005.png\" width=\"350\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>Rugger jersey spine:</strong> Characterized by <span class=\"customMeta\" data-dictid=\"1b5a7ceea716927771815e7283e571\">alternating</span> black and white striations, with sclerosed white end plates and black vertebral bodies; commonly seen in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"303281f8d5169277719437cf04ebaf\">osteodystrophy</span> (secondary hyperparathyroidism).</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Arambewela, Maulee &amp; Liyanarachchi, Kamani &amp; Somasundaram, Noel &amp; Pallewatte, Aruna &amp; Punchihewa, Gamini. \" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/ray-spine-showing-rugger-jersey-spine_fig3_318615259\" data-tags=\"\" height=\"489\" src=\"https://image.prepladder.com/content/x6V5VIxeaRlGoX8lBLrV1747382013.png\" width=\"350\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What statement accurately describes radiotherapy?", "options": [{"label": "A", "text": "Intensity is inversely proportional to square of the distance", "correct": true}, {"label": "B", "text": "Vomiting is a late adverse reaction", "correct": false}, {"label": "C", "text": "Rapidly proliferating cells are most radioresistant", "correct": false}, {"label": "D", "text": "All the adverse effects are reversible", "correct": false}], "correct_answer": "A. Intensity is inversely proportional to square of the distance", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Intensity is inversely proportional to square of th\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Whole-body CT scan protocol for a trauma patient includes all, except", "options": [{"label": "A", "text": "CT Head", "correct": false}, {"label": "B", "text": "CT Cervical spine", "correct": false}, {"label": "C", "text": "CT Limbs", "correct": true}, {"label": "D", "text": "CT Abdomen", "correct": false}], "correct_answer": "C. CT Limbs", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The following image of a FAST scan in a trauma patient suggests:", "options": [{"label": "A", "text": "Positive FAST", "correct": true}, {"label": "B", "text": "Negative FAST", "correct": false}, {"label": "C", "text": "Equivocal FAST", "correct": false}, {"label": "D", "text": "Pneumoperitoneum", "correct": false}], "correct_answer": "A. Positive FAST", "question_images": ["https://image.prepladder.com/content/7xwZ0KHjzRg7DNnzUWuv1715929793.png"], "explanation_images": ["https://image.prepladder.com/content/QQrYcleZvYweTQsf9IUF1715929826.png"], "explanation": "<p>Correct Option A: Positive FAST\n<table>\n<thead>\n<tr>\n<td>\n<p><strong>FAST Scan Findings</strong></p>\n</td>\n<td>\n<p><strong>Description</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p>Positive FAST</p>\n</td>\n<td>\n<p>Presence of <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> findings indicating internal <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> or organ injury</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Negative FAST</p>\n</td>\n<td>\n<p>Absence of <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> findings</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Equivocal FAST</p>\n</td>\n<td>\n<p>Inconclusive or uncertain findings requiring further evaluation</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which of the following scans does maximum radiation exposure occur?", "options": [{"label": "A", "text": "X-ray abdomen", "correct": false}, {"label": "B", "text": "Chest X ray", "correct": false}, {"label": "C", "text": "IV pyelography", "correct": false}, {"label": "D", "text": "CT", "correct": true}], "correct_answer": "D. CT", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Radiological Technique</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Radiation Exposure (Approximate)</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Chest X-ray</p>\n<p>Abdominal X-ray</p>\n</td>\n<td>\n<p>Low</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pelvic X-ray</p>\n<p>Lumbar Spine X-ray</p>\n</td>\n<td>\n<p>Low to Moderate</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>CT Scan (Head)</p>\n<p>CT Scan (Chest/Abdomen)</p>\n<p>CT Scan (Pelvis)</p>\n<p>Barium Swallow</p>\n<p>Barium Enema</p>\n<p>Angiography</p>\n</td>\n<td>\n<p>Moderate to High</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which imaging study is most effective in diagnosing cerebral infarct at the earliest stage?", "options": [{"label": "A", "text": "FLAIR MRI", "correct": false}, {"label": "B", "text": "Non-contrast CT", "correct": false}, {"label": "C", "text": "CECT", "correct": false}, {"label": "D", "text": "d. Diffusion weighted MRI", "correct": true}], "correct_answer": "D. d. Diffusion weighted MRI", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is a water soluble contrast?", "options": [{"label": "A", "text": "Iohexol", "correct": true}, {"label": "B", "text": "Barium", "correct": false}, {"label": "C", "text": "Bromium", "correct": false}, {"label": "D", "text": "Calcium", "correct": false}], "correct_answer": "A. Iohexol", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which dye is employed for the identification of esophageal perforation during diagnosis?", "options": [{"label": "A", "text": "Gastrografin", "correct": false}, {"label": "B", "text": "Iohexol", "correct": true}, {"label": "C", "text": "Gadolinium", "correct": false}, {"label": "D", "text": "Barium sulfate", "correct": false}], "correct_answer": "B. Iohexol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B: Ioh\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the subsequent investigations operate based on the same principle?", "options": [{"label": "A", "text": "CT and MRI", "correct": false}, {"label": "B", "text": "CT and X-ray", "correct": true}, {"label": "C", "text": "USG and HIDA Scan", "correct": false}, {"label": "D", "text": "MRI and PET Scan", "correct": false}], "correct_answer": "B. CT and X-ray", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Radiological Investigation</strong></p>\n</td>\n<td>\n<p><strong>Principle</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>X-ray</p>\n</td>\n<td>\n<p>Ionizing radiation is passed through the body, and the resulting image is captured on a detector.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Computed <span class=\"customMeta\" data-dictid=\"8d4f2a375b1692777200f41db641bc\">Tomography</span> (CT)</p>\n</td>\n<td>\n<p>X-ray beams <span class=\"customMeta\" data-dictid=\"ed17327223169277719753b0e5d6b4\">rotate</span> around the body, and multiple cross-sectional images are generated and reconstructed by a computer.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">Resonance</span> <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> (MRI)</p>\n</td>\n<td>\n<p>Powerful magnetic fields and radio waves are used to create detailed images of the body's structures based on the behavior of <span class=\"customMeta\" data-dictid=\"11f7bcb8da16927771898e93932195\">hydrogen</span> atoms in the body.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Ultrasound (USG)</p>\n</td>\n<td>\n<p>High-frequency sound waves are emitted and their reflections are used to create <span class=\"customMeta\" data-dictid=\"9ddd195e9a1692777197bb3f135c2e\">real-time</span> images of the internal organs.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Positron Emission <span class=\"customMeta\" data-dictid=\"8d4f2a375b1692777200f41db641bc\">Tomography</span> (PET)</p>\n</td>\n<td>\n<p>A <span class=\"customMeta\" data-dictid=\"f391426a781692777197a16039bb5e\">radioactive</span> <span class=\"customMeta\" data-dictid=\"887a04d130169277720091d7c1eeea\">tracer</span> is <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> into the body, and its distribution and <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> are detected to <span class=\"customMeta\" data-dictid=\"67407c787d1692777202245c791c31\">visualize</span> the <span class=\"customMeta\" data-dictid=\"bf1b7e7049169277720354c306d716\">functioning</span> of organs and tissues.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Single-Photon Emission <span class=\"customMeta\" data-dictid=\"44b07c254816927771855a12777513\">Computed Tomography</span> (SPECT)</p>\n</td>\n<td>\n<p>A <span class=\"customMeta\" data-dictid=\"f391426a781692777197a16039bb5e\">radioactive</span> <span class=\"customMeta\" data-dictid=\"887a04d130169277720091d7c1eeea\">tracer</span> is <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> into the body, and the emitted <span class=\"customMeta\" data-dictid=\"49be0416121692777188dc8944b7bc\">gamma</span> rays are detected to create three-dimensional images.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Mammography</p>\n</td>\n<td>\n<p>Low-dose <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-rays</span> are used to image the breast tissue, primarily for breast cancer screening and diagnosis.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Fluoroscopy</p>\n</td>\n<td>\n<p>Continuous <span class=\"customMeta\" data-dictid=\"fd0c8ab494169277720227102dc79a\">X-ray</span> beams are used to create <span class=\"customMeta\" data-dictid=\"9ddd195e9a1692777197bb3f135c2e\">real-time</span> moving images of the internal structures, such as the <span class=\"customMeta\" data-dictid=\"a32cad4dbc169277718669cfb165a5\">digestive</span> or <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> systems.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Bone Densitometry</p>\n</td>\n<td>\n<p>X-rays or <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> are used to measure the density of bones, helping diagnose <span class=\"customMeta\" data-dictid=\"4c8be6d6b716927771948551f98378\">osteoporosis</span> and assess <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> risk.</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the statements below are incorrect in relation to X Rays?", "options": [{"label": "A", "text": "Loss of soft tissue planes is the earliest X-ray chance of infection", "correct": false}, {"label": "B", "text": "Glass pieces can be seen in X-ray images", "correct": false}, {"label": "C", "text": "Joint space is a misnomer as there is no real space in the joint", "correct": false}, {"label": "D", "text": "Live bone is more radio-opaque than dead bone on X-Ray images.", "correct": true}], "correct_answer": "D. Live bone is more radio-opaque than dead bone on X-Ray images.", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not an example of ionizing radiation?", "options": [{"label": "A", "text": "Alpha rays", "correct": false}, {"label": "B", "text": "Beta rays", "correct": false}, {"label": "C", "text": "X-rays", "correct": false}, {"label": "D", "text": "MRI", "correct": true}], "correct_answer": "D. MRI", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D.\n<p><strong>Educational Objective:</strong></p>\n<ul><li>⤠Principles of MRI: Understand the basic principles underlying MRI, including nuclear magnetic resonance, the precession of hydrogen atoms, and the generation of a magnetic resonance signal. MRI Machine Components: Familiarize yourself with the components of an MRI machine, such as the main magnet, gradient coils, radiofrequency coils, and the computer system. Image Acquisition: Learn about the process of image acquisition in MRI, including data acquisition, pulse sequences, and the use of gradient fields to encode spatial information. Image Contrast: Understand the different types of image contrast in MRI, including T1-weighted, T2-weighted, and proton density-weighted images, and how they are influenced by the relaxation times of tissues. MRI Safety: Be aware of the safety considerations in MRI, including the potential risks associated with the strong magnetic field, radiofrequency energy, and the use of contrast agents. Understand the screening process for patients and the safety guidelines for staff. Clinical Applications: Explore the wide range of clinical applications of MRI, including imaging of the brain, spine, musculoskeletal system, abdomen, pelvis, and cardiovascular system. Understand the strengths and limitations of MRI compared to other imaging modalities. Contrast Agents: Learn about the use of contrast agents in MRI, such as gadolinium-based agents, for enhancing the visualization of certain tissues and pathologies. Advanced MRI Techniques: Gain knowledge of advanced MRI techniques, such as diffusion-weighted imaging, perfusion imaging, functional MRI (fMRI), spectroscopy, and diffusion tensor imaging (DTI). Artifacts: Understand common artifacts that can occur in MRI images, their causes, and strategies to minimize or correct them.</li><li>⤠Principles of MRI: Understand the basic principles underlying MRI, including nuclear magnetic resonance, the precession of hydrogen atoms, and the generation of a magnetic resonance signal.</li><li>⤠MRI Machine Components: Familiarize yourself with the components of an MRI machine, such as the main magnet, gradient coils, radiofrequency coils, and the computer system.</li><li>⤠Image Acquisition: Learn about the process of image acquisition in MRI, including data acquisition, pulse sequences, and the use of gradient fields to encode spatial information.</li><li>⤠Image Contrast: Understand the different types of image contrast in MRI, including T1-weighted, T2-weighted, and proton density-weighted images, and how they are influenced by the relaxation times of tissues.</li><li>⤠MRI Safety: Be aware of the safety considerations in MRI, including the potential risks associated with the strong magnetic field, radiofrequency energy, and the use of contrast agents. Understand the screening process for patients and the safety guidelines for staff.</li><li>⤠Clinical Applications: Explore the wide range of clinical applications of MRI, including imaging of the brain, spine, musculoskeletal system, abdomen, pelvis, and cardiovascular system. Understand the strengths and limitations of MRI compared to other imaging modalities.</li><li>⤠Contrast Agents: Learn about the use of contrast agents in MRI, such as gadolinium-based agents, for enhancing the visualization of certain tissues and pathologies.</li><li>⤠Advanced MRI Techniques: Gain knowledge of advanced MRI techniques, such as diffusion-weighted imaging, perfusion imaging, functional MRI (fMRI), spectroscopy, and diffusion tensor imaging (DTI).</li><li>⤠Artifacts: Understand common artifacts that can occur in MRI images, their causes, and strategies to minimize or correct them.</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the procedure.", "options": [{"label": "A", "text": "Myelography", "correct": true}, {"label": "B", "text": "Angiography", "correct": false}, {"label": "C", "text": "DEXA", "correct": false}, {"label": "D", "text": "Projectional radiography", "correct": false}], "correct_answer": "A. Myelography", "question_images": ["https://image.prepladder.com/content/kBVeVomdiMqP60og0cOa1688033898.png"], "explanation_images": [], "explanation": "<p>Correct Option A.\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the nature of the Doppler waveform of venous blood flow in lower limb deep vein thrombosis (DVT)?", "options": [{"label": "A", "text": "Monophasic", "correct": true}, {"label": "B", "text": "Biphasic", "correct": false}, {"label": "C", "text": "Triphasic", "correct": false}, {"label": "D", "text": "Multiphasic", "correct": false}], "correct_answer": "A. Monophasic", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 41 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient exposed to radiation presents with severe nausea, vomiting, and diarrhoea within a few days. Based on these symptoms, what is the expected radiation dose that has likely caused this Gastrointestinal Syndrome?", "options": [{"label": "A", "text": "1-5 Gy", "correct": false}, {"label": "B", "text": "5-20 Gy", "correct": true}, {"label": "C", "text": "20-30 Gy", "correct": false}, {"label": "D", "text": "&amp;gt;30 Gy", "correct": false}], "correct_answer": "B. 5-20 Gy", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:665px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Time Post-Exposure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms/Outcomes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prodromal Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0â2 days</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea, vomiting, anorexia, fever, headache, early skin <span class=\"customMeta\" data-dictid=\"f0f3e105661692777187df507b1f26\">erythema</span> (suggesting significant exposure<strong> &gt;2 Gy</strong>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Latent Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2â20 days</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Temporary symptom improvement; <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> lab results (lymphopenia, granulocytopenia) despite feeling well</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Manifest Illness Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>21â60 days</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symptoms vary by syndrome:</p>\n<ul>\n<li><strong>Hematopoietic syndrome </strong>(<strong>1-8 Gy</strong>, death in months):</li>\n<li><strong>Gastrointestinal syndrome</strong> (<strong>&gt;5 Gy</strong>, death in 2 weeks)</li>\n<li><strong>Neurovascular syndrome</strong> (<strong>&gt;20 Gy</strong>, death within 48 hours)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Final Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recovery or Death</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The outcome depends on the absorbed dose, dose rate, and exposure heterogeneity.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bx0EJN3kGzm0sjRC1s851745859605.mp3", "video": ""}, {"text": "A 55-year-old male presents to the emergency department with acute abdominal pain and altered bowel habits. The physician suspects abdominal pathology and considers various imaging studies, weighing concerns about radiation exposure. Which imaging modality would expose the patient to the highest level of radiation?", "options": [{"label": "A", "text": "CT scan of the abdomen", "correct": true}, {"label": "B", "text": "Barium enema", "correct": false}, {"label": "C", "text": "Lumbar spine X-ray", "correct": false}, {"label": "D", "text": "Micturating cystourethrogram (MCU)", "correct": false}], "correct_answer": "A. CT scan of the abdomen", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hazard Level</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Investigation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Effective Dose (mSv)</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DANGER</strong></p>\n</td>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PET/CT/Radionuclide Studies</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT Abdomen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>10</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT Thorax</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>8</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PET</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bone Scan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT Head</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2 - 3.5</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>WARNING</strong></p>\n</td>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnostic proceduresâ multiple views</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium Enema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>7</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium Meal follow-through</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium Meal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2.6</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium Swallow</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1.5</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Micturating <span class=\"customMeta\" data-dictid=\"7d3833cfbf1692777185c44c246cf4\">Cystourethrogram</span> (MCU)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1.2</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"6\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>SAFE</strong></p>\n</td>\n<td rowspan=\"6\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Spot radiographs: Only 1 or 2 <span class=\"customMeta\" data-dictid=\"fd0c8ab494169277720227102dc79a\">X-ray</span> exposures to the patient</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-ray <span class=\"customMeta\" data-dictid=\"683192f6b21692777191ae16feee76\">Lumbar</span> Spine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1 - 1.5</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-ray Abdomen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0.7 - 1.2</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hip Joint</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0.4</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Skull</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0.06</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CXR (PA View)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0.02</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Limb &amp; Joint (Except Hip)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>&lt;0.01</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Fb3y31GfMweqHnYDQquf1745893658.mp3", "video": ""}, {"text": "A 20-year-old female has recently started working in the radiology department and is concerned about radiation exposure. She seeks advice from the occupational health department. According to AERB guidelines, what is the maximum dose limit for occupational workers exposed to whole-body radiation in a year?", "options": [{"label": "A", "text": "50 mSv", "correct": false}, {"label": "B", "text": "20 mSv", "correct": false}, {"label": "C", "text": "30 mSv", "correct": true}, {"label": "D", "text": "15 mSv", "correct": false}], "correct_answer": "C. 30 mSv", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:663px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Part of the body </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Occupational Exposure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Public Exposure</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Whole body</strong></p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>20 mSv per year (averaged over 5 years) <strong>(Option B)</strong></p>\n<p>30 mSV in a year (maximum) <strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1mSv per year</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lens of the eyes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>150 mSv per year</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>15 mSv per year <strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Skin and Extremities (hand and feet)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>500 mSv in a year</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>50 mSv per year <strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pregnant radiation workers (once pregnancy is declared) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1 mSv (for the embryo/fetus)</p>\n<p>2 mSv (for the pregnant women)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/UyCcuOTl6MFTRnwmwmRY1745854251.mp3", "video": ""}, {"text": "A 25-year-old male who recently joined the radiology department was instructed to wear the device shown in the image. Which of the following statements about this device is incorrect?", "options": [{"label": "A", "text": "Assess the amount of radiation exposure", "correct": false}, {"label": "B", "text": "Comprise of thermoluminescent phosphors", "correct": false}, {"label": "C", "text": "Should be sent for dose monitoring every 3 months", "correct": false}, {"label": "D", "text": "It is worn over the lead apron", "correct": true}], "correct_answer": "D. It is worn over the lead apron", "question_images": ["https://image.prepladder.com/notes/R8hUsNnKKI1sdoq6d6Sy1743783977.png"], "explanation_images": ["https://image.prepladder.com/notes/svWGPpQFpjIQGMPaJfqb1743784018.png", "https://image.prepladder.com/notes/R8hUsNnKKI1sdoq6d6Sy1743783977.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:691px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TLD (Thermoluminescent Dosimeter) Badge</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is worn by individuals in radiation-exposed environments, such as medical <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> or nuclear facilities, to track their radiation dose and ensure it stays within safe limits.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Worn<strong> beneath </strong>the lead apron (as lead apron cuts off some radiation)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duration </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>According to the <span class=\"customMeta\" data-dictid=\"d07ff57c3f1692777182594c5f75ba\">Atomic Energy</span> Regulatory Board (AERB) of India, TLD badges are generally replaced and analyzed <strong>every 3 months</strong> to assess <span class=\"customMeta\" data-dictid=\"fa914a0d95169277718542753b513d\">cumulative</span> radiation exposure. <strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Composition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thermoluminescent phosphor crystals</strong>: <strong>(Option B)</strong></p>\n<ul>\n<li>Calcium <span class=\"customMeta\" data-dictid=\"535af9a2181692777199309af44d24\">sulfate</span> dysprosium</li>\n<li>Lithium fluoride</li>\n<li>Lithium borate</li>\n<li>Berrylium oxide</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Principle </strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA026\" data-author=\"\" data-hash=\"7540\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/svWGPpQFpjIQGMPaJfqb1743784018.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/17n9UlLYtEyM3ZBIvaeX1748959854.mp3", "video": ""}, {"text": "A 50-year-old female patient with a history of breast cancer is scheduled for a follow-up PET scan. During the consultation, she expresses concern about the long-term effects of radiation exposure. Which of the following statements regarding the stochastic effects of radiation exposure is correct?", "options": [{"label": "A", "text": "The severity of the effects is dose-dependent", "correct": false}, {"label": "B", "text": "It can also result in radiation-induced cataracts", "correct": false}, {"label": "C", "text": "No threshold dose is required for the occurrence", "correct": true}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "C. No threshold dose is required for the occurrence", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zYDI6C7kaeU7iFAD9kqn1743784140.png", "https://image.prepladder.com/notes/T3MqeRoIZZdDMSOmqrkt1743784202.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:683px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Deterministic Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stochastic Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Threshold dose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Required</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Not required (occur by chance, at any dose) <strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Severity </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dose-dependent</strong> <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dose-independent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Dose increased</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severity increases</p>\n<p><img alt=\"RA028\" data-author=\"\" data-hash=\"7541\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/zYDI6C7kaeU7iFAD9kqn1743784140.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>The <span class=\"customMeta\" data-dictid=\"f52ac1410416927771969ba21fcb63\">probability</span> of occurrence increases</strong></p>\n<p><img alt=\"RA029\" data-author=\"\" data-hash=\"7542\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/T3MqeRoIZZdDMSOmqrkt1743784202.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:124px\">\n<p style=\"text-align:center\"><strong>Examples </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:268px\">\n<ul>\n<li><strong>Radiation-induced <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> </strong><strong>(Option B)</strong></li>\n<li>Skin <span class=\"customMeta\" data-dictid=\"f0f3e105661692777187df507b1f26\">erythema</span> (most common side effect)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:291px\">\n<ul>\n<li>Radiation-induced cancer (most common is Leukemia)</li>\n<li>Congenital malformations</li>\n<li>Mutations</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DAGmviiKqzQmjtp329vg1745859353.mp3", "video": ""}, {"text": "In the context of the ALARA (As Low As Reasonably Achievable) principle, which of the following strategies is not aligned with minimising radiation exposure for healthcare workers during interventional procedures?", "options": [{"label": "A", "text": "Increasing the distance between the operator and the radiation source.", "correct": false}, {"label": "B", "text": "Continuous fluoroscopy instead of Pulsed fluoroscopy", "correct": true}, {"label": "C", "text": "Implementing lead shielding and personal protective equipment (PPE).", "correct": false}, {"label": "D", "text": "Reducing the duration of time the patient is exposed to radiation.", "correct": false}], "correct_answer": "B. Continuous fluoroscopy instead of Pulsed fluoroscopy", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9J7Vx4k9H2775F80B5sd1745860029.mp3", "video": ""}, {"text": "A 28-year-old woman arrives at the emergency department with acute abdominal pain. The attending physician is considering an abdominal X-ray. What does the \"10-day rule\" advise regarding X-ray exposure for women of childbearing age?", "options": [{"label": "A", "text": "A gap of at least 10 days between two successive X-rays.", "correct": false}, {"label": "B", "text": "Avoid non-urgent X-rays within 10 days post-menstruation", "correct": false}, {"label": "C", "text": "Perform X-rays during the first 10 days of the menstrual cycle.", "correct": true}, {"label": "D", "text": "X-rays should be avoided 10 days before menstruation.", "correct": false}], "correct_answer": "C. Perform X-rays during the first 10 days of the menstrual cycle.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lDTRMKZfjTwcYo29G7sW1745893414.mp3", "video": ""}, {"text": "A 45-year-old patient is scheduled for a CT scan to evaluate abdominal pain. The radiologist aims to ensure adequate visualization of the bowel without creating significant contrast between the bowel contents and surrounding tissues. Which of the following is a neutral contrast agent appropriate for this procedure?", "options": [{"label": "A", "text": "Barium", "correct": false}, {"label": "B", "text": "Iodinated contrast medium", "correct": false}, {"label": "C", "text": "Water", "correct": true}, {"label": "D", "text": "Air", "correct": false}], "correct_answer": "C. Water", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Contrast Media</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Positive contrast media</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Appear<strong> white </strong>on <span class=\"customMeta\" data-dictid=\"fd0c8ab494169277720227102dc79a\">X-ray</span> images due to greater <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> of <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-rays</span> than surrounding tissues.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Barium <strong>(Option A),</strong></li>\n<li>Iodinated solutions <strong>(Option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Negative contrast media</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Appear <strong>black</strong> due to less <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> of <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-rays</span> than surrounding tissues.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Air <strong>(Option C)</strong></li>\n<li>Carbon dioxide</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neutral contrast media</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Do not significantly alter <span class=\"customMeta\" data-dictid=\"fd0c8ab494169277720227102dc79a\">X-ray</span> attenuation, providing balanced contrast without adding brightness or darkness to the images.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Water</li>\n<li>Mannitol (draws water into <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> loop)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PyoVZYDrDZbfoZMgvrhS1746124076.mp3", "video": ""}, {"text": "A 35-year-old female is scheduled for an ERCP using the contrast mentioned below. Which type of contrast agent is it?", "options": [{"label": "A", "text": "Ionic Dimer", "correct": false}, {"label": "B", "text": "Non-ionic Dimer", "correct": false}, {"label": "C", "text": "Ionic Monomer", "correct": false}, {"label": "D", "text": "Non-ionic Monomer", "correct": true}], "correct_answer": "D. Non-ionic Monomer", "question_images": ["https://image.prepladder.com/notes/WRaAaR5rzlK6xYjndyo61743784485.png"], "explanation_images": ["https://image.prepladder.com/notes/bUZZB6sgZGCeUb37I4hJ1743784552.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<thead>\n<tr>\n<th colspan=\"4\" scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Iodine Particle Ratio</strong></p>\n</th>\n</tr>\n<tr>\n<th colspan=\"4\" rowspan=\"2\" scope=\"col\" style=\"vertical-align:top\">\n<ul>\n<li style=\"text-align:left\">Ionic = 2 particles</li>\n<li style=\"text-align:left\">Non-ionic = 1 particle</li>\n<li style=\"text-align:left\">Monomer = 3 iodine</li>\n<li style=\"text-align:left\">Dimer = 6 iodine</li>\n</ul>\n</th>\n</tr>\n<tr>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ionic Monomer</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ionic Dimer</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-ionic Monomer</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-ionic Dimer</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3:2</p>\n<p>(High osmolality)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3:1</p>\n<p>(Low osmolality)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3:1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6:1</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Iodine Contrast</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Routes of administration</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intravenous and Intra-arterial</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Indications</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Commonly used for contrast in CECT (3D X-ray), Interventional Radiology, and <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-rays</span> like as in</p>\n<ul>\n<li>Intravenous pyelogram</li>\n<li>Micturating cystourethrogram</li>\n<li>Hysterosalpingography</li>\n<li>Retrograde pyelography</li>\n<li>ERCP- <span class=\"customMeta\" data-dictid=\"35ca8c2d5f16927771879351e8f97e\">Endoscopic</span> <span class=\"customMeta\" data-dictid=\"e38ca8e6931692777197ee6a68ac56\">retrograde</span> cholangiopancreatography</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Reactions</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Physiological Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Allergic Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Post-contrast <span class=\"customMeta\" data-dictid=\"f3063c1d8b169277719018bf869980\">induced</span> nephropathy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea</li>\n<li>Vomiting</li>\n<li>Flushing</li>\n<li>Headaches</li>\n<li>Vasovagal reaction</li>\n<li>Arrhythmias</li>\n<li>Seizures</li>\n</ul>\n\t\t\t \n\n\t\t\t<p>-</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mild reactions:</strong></p>\n<ul>\n<li>Hives (Urticaria)</li>\n<li>Erythema (Redness of skin)</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Moderate to severe reactions:</strong></p>\n<ul>\n<li><strong>Wheezing</strong></li>\n<li><strong>Anaphylactoid reactions (Non-IgE mediated)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Also known as <strong>Contrast-Induced <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">Kidney</span> Injury (AKI)</strong>.</li>\n<li>It is defined as an increase in <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"2ead0fd0301692777185187bd72768\">creatinine</span> by <strong>&gt; 0.5 mg/dL</strong> or a <strong>&gt; 25% rise</strong> from the <span class=\"customMeta\" data-dictid=\"3c8a051a89169277718256c92278c5\">baseline</span> within <strong>3 days</strong> of contrast administration, without any other clear cause.</li>\n<li><strong>Risk factors:</strong>\n<ul>\n<li>Patients with pre-existing <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease.</li>\n<li><strong>Pre-contrast eGFR &lt; 60 mL/min/1.73 m²</strong> indicates higher risk.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management:</strong></p>\n<p>Observation for mild reactions</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management:</strong></p>\n<ul>\n<li><strong>Mild reactions: </strong>Antihistamines (e.g., Diphenhydramine)</li>\n<li><strong>Severe reactions: </strong>Requires <span class=\"customMeta\" data-dictid=\"76baf6616a169277718738f8790ab9\">epinephrine</span> and advanced <span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\">airway</span> management as needed.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management:</strong></p>\n<p><strong>Intravenous hydration</strong> (e.g., normal saline)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KBgLemt2nxN5hdK1J6Cl1746124360.mp3", "video": ""}, {"text": "A 42-year-old female with a history of ulcerative colitis presents with severe abdominal pain and diarrhoea. The gastroenterologist is considering performing a barium study to assess her condition. Which of the following conditions would contraindicate using a barium study in this patient?", "options": [{"label": "A", "text": "Malabsorption syndrome", "correct": false}, {"label": "B", "text": "Colon carcinoma", "correct": false}, {"label": "C", "text": "Ileocecal Tuberculosis", "correct": false}, {"label": "D", "text": "Inflammatory bowel disease (IBD) exacerbation", "correct": true}], "correct_answer": "D. Inflammatory bowel disease (IBD) exacerbation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:638px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conditions</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium Swallow</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>To evaluate normal <span class=\"customMeta\" data-dictid=\"1788e0d4301692777199d457616bd4\">swallowing</span> function.</li>\n<li>Suspected oesophagal disorders (e.g., strictures, tumours)</li>\n<li>Achalasia cardia</li>\n<li>Zenkers diverticulum</li>\n<li>Hiatus hernia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium Meal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>To evaluate normal <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> emptying</li>\n<li>Evaluation of <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> and duodenal conditions (e.g., ulcers, carcinoma, pyloric stenosis)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium Meal Follow-Through</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Assessment of small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> disorders</li>\n<li>Malabsorption syndrome <strong>(Option A)</strong></li>\n<li>Ileocecal TB <strong>(Option C)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium Enema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Assessment of lower <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> (e.g. <span class=\"customMeta\" data-dictid=\"566fcef0991692777184068f36db82\">Colonic</span> carcinoma) <strong>(Option B)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Iam9YcjUtdyZZ0hCuE9O1746124505.mp3", "video": ""}, {"text": "A 35-year-old pregnant woman is being assessed for suspected appendicitis. An abdominal ultrasound shows inflammation but in limited detail. What is the best contrast agent to enhance USG?", "options": [{"label": "A", "text": "Barium sulfate", "correct": false}, {"label": "B", "text": "Iodinated contrast agents", "correct": false}, {"label": "C", "text": "Saline solution", "correct": false}, {"label": "D", "text": "Sulfur Hexafluoride microbubbles", "correct": true}], "correct_answer": "D. Sulfur Hexafluoride microbubbles", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:665px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contrast agents for USG</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Sonovue</strong> (sulfur hexafluoride)</li>\n<li><strong>Lumason</strong> (sulfur hexafluoride)</li>\n<li><strong>Definity</strong> (perflutren)</li>\n<li><strong>Sonozoid</strong> (perflubutane)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Preferred route</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intravenous</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Eliminated by</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lungs</strong> <strong>(hence safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> conditions)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Liver lesions</li>\n<li>Micturating cystosonography</li>\n<li>Renal lesions</li>\n<li>Obstruction in Crohn's disease</li>\n<li>Evaluation of Aortic <span class=\"customMeta\" data-dictid=\"f2c92eaffe16927771819978aa5666\">aneurysm</span> repair</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is the safest contrast media and rarely causes mild <span class=\"customMeta\" data-dictid=\"245b6a0cc91692777181d63c66b3a3\">anaphylactoid</span> reactions.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/w89DSU4QQH9fnHD1S7Qt1746125231.mp3", "video": ""}, {"text": "A 70-year-old patient with multiple comorbidities is being evaluated for contrast-enhanced imaging. The healthcare team is assessing risk factors for contrast-induced nephropathy (CIN). Which of the following is NOT considered a risk factor for CIN?", "options": [{"label": "A", "text": "History of diabetes", "correct": false}, {"label": "B", "text": "Use of metformin", "correct": false}, {"label": "C", "text": "Use of nonsteroidal anti-inflammatory drugs (NSAIDs)", "correct": false}, {"label": "D", "text": "History of asthma", "correct": true}], "correct_answer": "D. History of asthma", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bx7i3uLCAQK8ycDl9At41746125548.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 22 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "IOC for Ureteric calculi is?", "options": [{"label": "A", "text": "USG", "correct": false}, {"label": "B", "text": "NC-CT", "correct": true}, {"label": "C", "text": "CE-CT", "correct": false}, {"label": "D", "text": "Ureteroscopy", "correct": false}], "correct_answer": "B. NC-CT", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which of the following scans does maximum radiation exposure occur?", "options": [{"label": "A", "text": "X-ray abdomen", "correct": false}, {"label": "B", "text": "Chest X ray", "correct": false}, {"label": "C", "text": "IV pyelography", "correct": false}, {"label": "D", "text": "CT", "correct": true}], "correct_answer": "D. CT", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/DG1sjU3rsTT3XISrCXwx1748158843.png"], "explanation": "<p>Correct Answer D- CT\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 12 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 45-year-old male patient presents with dyspnea on exertion and occasional palpitations. A chest X-ray is performed, revealing the cardiac silhouette. Study the image provided and answer the following question. Which of the following statements regarding the heart's position, size, and borders on the chest radiograph is correct?", "options": [{"label": "A", "text": "The right heart border is formed primarily by the right ventricle.", "correct": false}, {"label": "B", "text": "The left atrium primarily forms the left heart border.", "correct": false}, {"label": "C", "text": "The cardiothoracic ratio (CTR) is considered normal if it is less than 0.5 on a PA chest X-ray.", "correct": true}, {"label": "D", "text": "The right atrium and the left ventricle mainly form the inferior border of the heart.", "correct": false}], "correct_answer": "C. The cardiothoracic ratio (CTR) is considered normal if it is less than 0.5 on a PA chest X-ray.", "question_images": ["https://image.prepladder.com/notes/0NvoxRWMou3JErZzxyS91743079693.png"], "explanation_images": ["https://image.prepladder.com/notes/hIObbTbynjshgNQAfCTq1743079694.png", "https://image.prepladder.com/notes/xzzw0g81UkVNjnFvQCzL1747219736.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "You are shown a CT scan of the chest. The scan is taken in the arterial phase. Based on the anatomy and contrast enhancement, identify the structure marked as âAâ by the arrow.", "options": [{"label": "A", "text": "Left atrium", "correct": true}, {"label": "B", "text": "Ascending Aorta", "correct": false}, {"label": "C", "text": "Pulmonary trunk", "correct": false}, {"label": "D", "text": "Right Atrium", "correct": false}], "correct_answer": "A. Left atrium", "question_images": ["https://image.prepladder.com/notes/7aoYhDL3PP8GRtaJ2Umq1743079695.png"], "explanation_images": ["https://image.prepladder.com/notes/1nCRrtCCCpILeqZSa5Bs1743079696.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QWNqNCsNb5iqWCaOWZr01746165905.mp3", "video": ""}, {"text": "A 3-year-old child presents with cyanosis and difficulty in breathing during physical exertion. On physical examination, the patient has a harsh systolic murmur heard best at the left upper sternal border. A chest X-ray is performed and it shows the following features. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Transposition of the Great Arteries (TGA)", "correct": false}, {"label": "B", "text": "Tetralogy of Fallot (TOF)", "correct": true}, {"label": "C", "text": "Total Anomalous Pulmonary Venous Connection (TAPVC)", "correct": false}, {"label": "D", "text": "Tricuspid Atresia", "correct": false}], "correct_answer": "B. Tetralogy of Fallot (TOF)", "question_images": ["https://image.prepladder.com/notes/VbfXW4SCAh4xa72Z6ygs1746166788.png"], "explanation_images": ["https://image.prepladder.com/notes/2niLkdo06Mb4D0A2HlGz1746166950.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/EubFQ8A1Ia1t6yWhZtq91746531189.mp3", "video": ""}, {"text": "A 5-month-old male infant presents with cyanosis, difficulty breathing, and failure to thrive. On physical examination, a loud second heart sound (S2) is heard, and there are signs of pulmonary congestion. The patientâs chest X-ray is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Partial anomalous pulmonary venous return (PAPVR)", "correct": false}, {"label": "B", "text": "Tetralogy of Fallot (TOF)", "correct": false}, {"label": "C", "text": "Transposition of the great arteries (TGA)", "correct": false}, {"label": "D", "text": "Total anomalous pulmonary venous connection (TAPVC)", "correct": true}], "correct_answer": "D. Total anomalous pulmonary venous connection (TAPVC)", "question_images": ["https://image.prepladder.com/notes/N3yIErEsL4IuocgOjS5o1746167213.png"], "explanation_images": ["https://image.prepladder.com/notes/hULKJb41MZyG5L10PVTa1743080331.png", "https://image.prepladder.com/notes/g20gY5hqxfS460GP1mLn1743080331.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LQJE8MMBwWx9jwW5PNri1746634362.mp3", "video": ""}, {"text": "A 25-year-old male presents with mild exertional dyspnea. Clinical examination reveals a fixed split S2 and a systolic ejection murmur at the left upper sternal border. A chest X-ray shows the following features. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Partial Anomalous Pulmonary Venous Connection (PAPVC)", "correct": true}, {"label": "B", "text": "Ventricular Septal Defect (VSD)", "correct": false}, {"label": "C", "text": "Mitral Stenosis", "correct": false}, {"label": "D", "text": "Total Anomalous Pulmonary Venous Connection (TAPVC)", "correct": false}], "correct_answer": "A. Partial Anomalous Pulmonary Venous Connection (PAPVC)", "question_images": ["https://image.prepladder.com/notes/mUfE3nX872j7W7QvMUWN1743080332.png"], "explanation_images": ["https://image.prepladder.com/notes/KgatkHp8ZQC8vKKCUoDO1747215689.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 31-year-old man presents with dyspnea, orthopnea and fatigue. The radiological images are attached below. Based on the given information, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute pericarditis", "correct": false}, {"label": "B", "text": "Calcific constrictive pericarditis", "correct": true}, {"label": "C", "text": "Cardiac tamponade", "correct": false}, {"label": "D", "text": "Myocardial infarction", "correct": false}], "correct_answer": "B. Calcific constrictive pericarditis", "question_images": ["https://image.prepladder.com/notes/Rz9BwPNjaeL6s1KvVgpv1743080332.png"], "explanation_images": ["https://image.prepladder.com/notes/Jn9BilINGgOhPiadjPRa1743080648.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:739px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Often idiopathic, can be secondary to infection, radiation, or <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> diseases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thickened, fibrotic, and <span class=\"customMeta\" data-dictid=\"0fcf4dea9916927771839d83b967db\">calcified pericardium</span> restricting <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> filling</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dyspnea, fatigue, chest pain, signs of <span class=\"customMeta\" data-dictid=\"72421e3a581692777197a98d00066c\">right heart</span> failure</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT Findings (IOC)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>⢠Thickened <span class=\"customMeta\" data-dictid=\"56ab21797f16927771954b343891ef\">pericardium</span> (&gt;4 mm), often calcified</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"85bd8b2ec816927771958f9ebe3568\">Pericardial</span> <span class=\"customMeta\" data-dictid=\"73909075e71692777187f08d3c9b7e\">effusion</span> may be present</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">Dilation</span> of <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"3ddf6d5ea71692777201b70c8b9715\">vena</span> <span class=\"customMeta\" data-dictid=\"67544ba6ef16927771835d4641cc8f\">cava</span> and <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> veins</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Other Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardiac MRI- </strong>To measure <span class=\"customMeta\" data-dictid=\"85bd8b2ec816927771958f9ebe3568\">pericardial</span> thickness</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9Gm7iH5CkSoeGYZaIULD1746634683.mp3", "video": ""}, {"text": "A 3-day-old newborn is brought to the emergency department with marked central cyanosis. On examination, his heart rate is 160 bpm, respiratory rate is 65 breaths/min, and oxygen saturation is 80% on room air. A chest radiograph is performed, showing cardiomegaly with a characteristic \"egg on a string\" appearance. If an echocardiogram is conducted, which of the following echocardiographic findings would be most consistent with the suspected condition?", "options": [{"label": "A", "text": "Ventricular septal defect with overriding aorta", "correct": false}, {"label": "B", "text": "Single great artery arising from the heart", "correct": false}, {"label": "C", "text": "Parallel great vessels with the aorta anterior and slightly to the right of the pulmonary artery", "correct": true}, {"label": "D", "text": "Abnormal pulmonary venous connections to the right atrium", "correct": false}], "correct_answer": "C. Parallel great vessels with the aorta anterior and slightly to the right of the pulmonary artery", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/FL9RXvG8n8HfgVRC4Tn11743080808.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>D-Loop TGA (</strong><strong>dextro-transposition of the great arteries)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>L-Loop TGA (Congenitally Corrected)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pathology</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"ce68eab48a1692777181c719b4344e\">aorta</span> originates from the right <span class=\"customMeta\" data-dictid=\"707de303e516927772011cb80f4028\">ventricle</span> and the <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> trunk from the left ventricle, creating two <span class=\"customMeta\" data-dictid=\"635a7ea50e16927771944f08f17aed\">parallel</span> <span class=\"customMeta\" data-dictid=\"f3739d892c1692777184b2e134615c\">circulatory</span> circuits.</li>\n<li>This condition is life-threatening unless a shunt, like a patent <span class=\"customMeta\" data-dictid=\"7a6864e97b169277718602072817ee\">ductus</span> arteriosus (PDA) or septal defect, is present to allow blood mixing.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Congenitally corrected TGA (ccTGA) is characterized by both <span class=\"customMeta\" data-dictid=\"d77b211e3a1692777182121ece27fc\">atrioventricular</span> and ventriculoarterial discordance, a condition <span class=\"customMeta\" data-dictid=\"047f8930dd1692777197fed61e213c\">referred</span> to as \"double discordance.\"</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>X-ray</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cardiomegaly</li>\n<li>\"Egg on a string\" appearance</li>\n<li>Narrow mediastinum</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> markings</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mesocardia or levocardia</li>\n<li>Straight <span class=\"customMeta\" data-dictid=\"9a065f288c1692777191f5b93fa49b\">left heart</span> border</li>\n<li>Abnormally straight <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> pedicle</li>\n<li>Possible bulge along upper left <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> border</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Cs0NyZ83Ck9ljlMUGIOV1746634857.mp3", "video": ""}, {"text": "A 16-year-old female presents to the emergency department with complaints of shortness of breath and palpitations. A chest X-ray is performed, and the radiologist notes a distinctive cardiac silhouette, as shown in the image. Which of the following best describes the cardiac abnormality suggested by this radiographic appearance?", "options": [{"label": "A", "text": "Boot-shaped heart; Tetralogy of Fallot", "correct": false}, {"label": "B", "text": "Box-shaped heart; Ebstein anomaly", "correct": true}, {"label": "C", "text": "Egg-on-string appearance; Transposition of the Great Arteries", "correct": false}, {"label": "D", "text": "Snowman sign; Total Anomalous Pulmonary Venous Return", "correct": false}], "correct_answer": "B. Box-shaped heart; Ebstein anomaly", "question_images": ["https://image.prepladder.com/notes/8piUiffT0SVQHkzkY2IH1743080809.png"], "explanation_images": ["https://image.prepladder.com/notes/1OQlIHNCXJbDwQXZL8iW1743080809.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Rk2S02Wdu4YHJo0lSCyv1746635001.mp3", "video": ""}, {"text": "A 45-year-old woman presents with gradually worsening dyspnea and reduced exercise tolerance over the past month. The chest X-ray is given below. Regarding this patient's condition, which of the following statements is INCORRECT?", "options": [{"label": "A", "text": "\"Oreo cookie\" sign will be seen on lateral view on Chest X Ray", "correct": false}, {"label": "B", "text": "The patient typically shows abrupt enlargement of cardiothoracic ratio", "correct": true}, {"label": "C", "text": "Seldinger technique is employed for management of this condition", "correct": false}, {"label": "D", "text": "An Echocardiogram is a better modality than CT to confirm the diagnosis", "correct": false}], "correct_answer": "B. The patient typically shows abrupt enlargement of cardiothoracic ratio", "question_images": ["https://image.prepladder.com/notes/A6sKnj082qmHznxvi7NC1743080811.png"], "explanation_images": ["https://image.prepladder.com/notes/qQ8pBBprrrsgCgtCArYt1743081373.png", "https://image.prepladder.com/notes/6gNC7Eg7ZBU4jxqIROTC1743081374.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:715px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Plain Radiograph</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>⢠<span class=\"customMeta\" data-dictid=\"7fb01b5ad51692777188c3cb1733f9\">Globular</span> <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> of <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> shadow</p>\n<p>⢠\"Water bottle\" configuration</p>\n<p>⢠Widening of the <span class=\"customMeta\" data-dictid=\"b431f15ea816927771991371611d2f\">subcarinal</span> angle</p>\n<p>⢠\"Oreo cookie\" sign on <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> view <strong>(Option A)</strong></p>\n<p>⢠Serially enlarging <span class=\"customMeta\" data-dictid=\"9e9e83e07116927771834235fe8fa2\">cardiothoracic</span> ratio</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>⢠Usually visible when &gt;200 mL of fluid present</p>\n<p>⢠May show signs of <span class=\"customMeta\" data-dictid=\"25ec593008169277718360336a849a\">cardiogenic</span> <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> in severe cases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Echocardiography</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>⢠<span class=\"customMeta\" data-dictid=\"acb59b05f31692777181d2df5f618b\">Anechoic</span> separation of <span class=\"customMeta\" data-dictid=\"85bd8b2ec816927771958f9ebe3568\">pericardial</span> layers</p>\n<p>⢠Fluid first appears posteriorly in <span class=\"customMeta\" data-dictid=\"b0976ea1fd16927771995d5c700a21\">supine</span> patients</p>\n<p>⢠Depth of <span class=\"customMeta\" data-dictid=\"73909075e71692777187f08d3c9b7e\">effusion</span> correlates with volume</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>⢠Method of choice for diagnosis <strong>(Option D)</strong></p>\n<p>⢠Can detect as little as 50 mL of fluid</p>\n<p>⢠Allows assessment of <span class=\"customMeta\" data-dictid=\"cdf4a197dd16927771881a652c8328\">hemodynamic</span> impact</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>⢠Fluid density material surrounding the heart</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"85bd8b2ec816927771958f9ebe3568\">Pericardial</span> <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> &gt;3-4 mm is <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> and suggestive of effusion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>⢠Often used to <span class=\"customMeta\" data-dictid=\"b0cb92d8181692777184478e3a24f2\">clarify</span> cause rather than confirm diagnosis</p>\n<p>⢠Can help <span class=\"customMeta\" data-dictid=\"c9001edbf216927771860f3475b44c\">differentiate</span> from other conditions (e.g., hemopericardium)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2PO8NZaPS5Dl5ddWh0Bp1746635690.mp3", "video": ""}, {"text": "A 68-year-old female patient presents to the emergency department with complaints of increasing shortness of breath over the past few weeks and occasional palpitations. She has a history of hypertension and was diagnosed with mitral stenosis five years ago. A chest X-ray is performed, and the radiologist notes specific findings. Based on the chest X-ray findings, which of the following features is most indicative of the condition observed?", "options": [{"label": "A", "text": "Elevation of the left main bronchus", "correct": true}, {"label": "B", "text": "Widening of the mediastinum", "correct": false}, {"label": "C", "text": "Presence of pleural effusion", "correct": false}, {"label": "D", "text": "Cardiomegaly with a normal heart border", "correct": false}], "correct_answer": "A. Elevation of the left main bronchus", "question_images": ["https://image.prepladder.com/notes/A0lbvREWEUhmBXyFWHNm1743081375.png"], "explanation_images": ["https://image.prepladder.com/notes/Aq2DtcLT9AiVf5oghSs11743687534.png", "https://image.prepladder.com/notes/A0lbvREWEUhmBXyFWHNm1743081375.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ptFtHjGjti8mi28D79AM1746680830.mp3", "video": ""}, {"text": "In mitral stenosis, which Mogul sign is seen?", "options": [{"label": "A", "text": "First", "correct": false}, {"label": "B", "text": "second", "correct": false}, {"label": "C", "text": "Third", "correct": true}, {"label": "D", "text": "Fourth", "correct": false}], "correct_answer": "C. Third", "question_images": ["https://image.prepladder.com/notes/XrqsDZGGdeJT9RiveX201743081376.png"], "explanation_images": ["https://image.prepladder.com/notes/0JQm6MI9uciCS3YVw8nF1743084349.png", "https://image.prepladder.com/notes/XXKNkWM9TBeKCaydkcbu1743084350.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TJDJkv5SN3r1Aw2VNQTC1746681024.mp3", "video": ""}, {"text": "A 70-year-old male patient presents to the emergency department with acute respiratory distress following a severe allergic reaction. He has a history of asthma and reports recent exposure to a known allergen. Chest X-ray of the patient is given below. Which of the following findings on the chest X-ray is NOT characteristic of the patientâs condition?", "options": [{"label": "A", "text": "Batâs Wing Distribution", "correct": false}, {"label": "B", "text": "Air Bronchogram", "correct": false}, {"label": "C", "text": "Widened Mediastinum", "correct": true}, {"label": "D", "text": "Kerley B lines", "correct": false}], "correct_answer": "C. Widened Mediastinum", "question_images": ["https://image.prepladder.com/notes/aHfm9MtJEsBYVEuPXUAo1746789132.png"], "explanation_images": ["https://image.prepladder.com/notes/95QZiaPVQOEy2HKvmBJr1743084278.png"], "explanation": "<p><strong>References:</strong></p>\n<ul><li>âł Interstitial Edema Signs: Kerley B Lines: Short horizontal lines at lung periphery due to fluid in the interlobular septa. (Option D ruled out) Kerley A Lines: Longer lines directed towards the hilum (more difficult to detect). Peribronchial Cuffing: Thickening and blurring of airway walls due to fluid accumulation. Perihilar Haze: Blurring of central lung vessels due to fluid in perivascular spaces.</li><li>âł Interstitial Edema Signs:</li><li>âł Kerley B Lines: Short horizontal lines at lung periphery due to fluid in the interlobular septa. (Option D ruled out) Kerley A Lines: Longer lines directed towards the hilum (more difficult to detect). Peribronchial Cuffing: Thickening and blurring of airway walls due to fluid accumulation. Perihilar Haze: Blurring of central lung vessels due to fluid in perivascular spaces.</li><li>âł Kerley B Lines: Short horizontal lines at lung periphery due to fluid in the interlobular septa. (Option D ruled out)</li><li>âł Kerley B Lines:</li><li>âł (Option D ruled out)</li><li>âł Kerley A Lines: Longer lines directed towards the hilum (more difficult to detect).</li><li>âł Kerley A Lines:</li><li>âł Peribronchial Cuffing: Thickening and blurring of airway walls due to fluid accumulation.</li><li>âł Peribronchial Cuffing:</li><li>âł Perihilar Haze: Blurring of central lung vessels due to fluid in perivascular spaces.</li><li>âł Perihilar Haze:</li><li>âł Alveolar Edema Signs: Bilateral Opacification: Fluid in alveoli causing diffuse clouding of lung fields. Batâs Wing Distribution: Central lung opacities with sparing of the peripheries. (Option A ruled out) Air Bronchogram: Visible air-filled bronchi surrounded by fluid-filled alveoli. (Option B ruled out) Rapid Changes in Opacity: Quick development of opacities suggests edema rather than infection.</li><li>âł Alveolar Edema Signs:</li><li>âł Bilateral Opacification: Fluid in alveoli causing diffuse clouding of lung fields. Batâs Wing Distribution: Central lung opacities with sparing of the peripheries. (Option A ruled out) Air Bronchogram: Visible air-filled bronchi surrounded by fluid-filled alveoli. (Option B ruled out) Rapid Changes in Opacity: Quick development of opacities suggests edema rather than infection.</li><li>âł Bilateral Opacification: Fluid in alveoli causing diffuse clouding of lung fields.</li><li>âł Bilateral Opacification:</li><li>âł Batâs Wing Distribution: Central lung opacities with sparing of the peripheries. (Option A ruled out)</li><li>âł Batâs Wing Distribution:</li><li>âł (Option A ruled out)</li><li>âł Air Bronchogram: Visible air-filled bronchi surrounded by fluid-filled alveoli. (Option B ruled out)</li><li>âł Air Bronchogram:</li><li>âł (Option B ruled out)</li><li>âł Rapid Changes in Opacity: Quick development of opacities suggests edema rather than infection.</li><li>âł Rapid Changes in Opacity:</li><li>âł Other Findings: Pleural Effusions: Fluid can accumulate between the lung and pleura, seen at costophrenic angles. Upper Lobe Sparing: Edema often spares upper lobes, with a preference for lower lung zones. Peripheral Edema: In NCPE (like ARDS), peripheral lung regions may show more edema than central areas.</li><li>âł Other Findings:</li><li>âł Pleural Effusions: Fluid can accumulate between the lung and pleura, seen at costophrenic angles. Upper Lobe Sparing: Edema often spares upper lobes, with a preference for lower lung zones. Peripheral Edema: In NCPE (like ARDS), peripheral lung regions may show more edema than central areas.</li><li>âł Pleural Effusions: Fluid can accumulate between the lung and pleura, seen at costophrenic angles.</li><li>âł Pleural Effusions:</li><li>âł Upper Lobe Sparing: Edema often spares upper lobes, with a preference for lower lung zones.</li><li>âł Upper Lobe Sparing:</li><li>âł Peripheral Edema: In NCPE (like ARDS), peripheral lung regions may show more edema than central areas.</li><li>âł Peripheral Edema:</li></u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male with hypertension, hyperlipidemia, and a smoking history presents for a routine evaluation. He has no symptoms but is concerned about cardiovascular health due to a family history of heart disease. Which score is used to assess coronary artery disease risk?", "options": [{"label": "A", "text": "CHA2DS2-VASc Score", "correct": false}, {"label": "B", "text": "Agatston Score", "correct": true}, {"label": "C", "text": "Reynolds Risk Score", "correct": false}, {"label": "D", "text": "Carotid Intima-Media Thickness", "correct": false}], "correct_answer": "B. Agatston Score", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/uFlSmVZZvimOUC44OcEm1743083981.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ryVNg0igycRVk76Sc7d41746698824.mp3", "video": ""}, {"text": "A 58-year-old male with a history of hypertension and recent long-distance travel presents with sudden chest pain and dyspnea. A Computed Tomography Pulmonary Angiography (CTPA) is performed, and the findings are given below. Which of the following statements regarding the findings associated with the given condition is FALSE?", "options": [{"label": "A", "text": "Hampton Hump indicates hemorrhage and necrotic lung tissue in pulmonary infarction.", "correct": false}, {"label": "B", "text": "The Westermark Sign shows regional oligemia due to reduced blood flow.", "correct": false}, {"label": "C", "text": "Chang Sign shows an enlargement of the right descending pulmonary artery.", "correct": true}, {"label": "D", "text": "Palla Sign indicates enlargement of the right descending pulmonary artery.", "correct": false}], "correct_answer": "C. Chang Sign shows an enlargement of the right descending pulmonary artery.", "question_images": ["https://image.prepladder.com/notes/F38cpllQ5VxpfM0KSSY61743082233.png"], "explanation_images": ["https://image.prepladder.com/notes/CWbvwrWwNj6MZjG76FBu1743082233.png", "https://image.prepladder.com/notes/KwBKRJTXqz07gvkyKdlW1743082233.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YWQuCNjIQT3MFXYczzGX1746700007.mp3", "video": ""}, {"text": "A 10-year-old boy presents with brachio-femoral pulse delay and a history of recurrent chest pain. A chest X-ray is performed, revealing a contour abnormality of the aorta and rib notching. Which of the following radiographic features is most likely observed in this patient?", "options": [{"label": "A", "text": "Figure of 3 sign", "correct": true}, {"label": "B", "text": "Widened mediastinum", "correct": false}, {"label": "C", "text": "Kerley B lines", "correct": false}, {"label": "D", "text": "Enlarged cardiac silhouette", "correct": false}], "correct_answer": "A. Figure of 3 sign", "question_images": ["https://image.prepladder.com/notes/HoWutOxcRvALl3rzC8uj1743853975.png"], "explanation_images": ["https://image.prepladder.com/notes/HakFkWmXD0XO8EAE0if31743854131.png", "https://image.prepladder.com/notes/A2p42mP8J5Z8PAvQmoWf1743083790.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ht4Jb0pRFsnzyGL9qYWs1746776066.mp3", "video": ""}, {"text": "A 72-year-old male with a history of hypertension and hyperlipidemia presents to the emergency department with sudden, severe abdominal pain radiating to the back. A CT angiogram is given below. Which of the following radiological signs on the CT angiogram indicates an impending rupture of the patient's condition?", "options": [{"label": "A", "text": "Retroperitoneal hematoma", "correct": false}, {"label": "B", "text": "Contrast extravasation", "correct": false}, {"label": "C", "text": "Draped aorta sign", "correct": true}, {"label": "D", "text": "Para-aortic fat stranding", "correct": false}], "correct_answer": "C. Draped aorta sign", "question_images": ["https://image.prepladder.com/notes/TmFqh8LYiN1anef6GPgx1743082147.png"], "explanation_images": ["https://image.prepladder.com/notes/4HaOM0xIfiyiM5sMNtsK1743082148.png", "https://image.prepladder.com/notes/zN8t7aw66C1yLbECba3F1743082149.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FgJ1nUdHmefzRXQH9EPt1746776231.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 26 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 12-week-old child presented with fever, cyanosis, and fatigue. His chest X-ray is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Total anomalous pulmonary venous circulation", "correct": true}, {"label": "B", "text": "Tetralogy of Fallot", "correct": false}, {"label": "C", "text": "Transposition of great arteries", "correct": false}, {"label": "D", "text": "Pericardial effusion", "correct": false}], "correct_answer": "A. Total anomalous pulmonary venous circulation", "question_images": ["https://image.prepladder.com/content/lJ8hOGhYjYwYBwvPhNbS1748200258.png"], "explanation_images": ["https://image.prepladder.com/content/gs6hZkDRhtbFyExSyeUv1745412460.png", "https://image.prepladder.com/content/ijzwd7LCSPmFKNcYfwwv1745412477.png", "https://image.prepladder.com/content/F8sWpzBnka8PPky6pOKt1745412487.png", "https://image.prepladder.com/content/MQVJUrhRhRUuCVQtXGq91745412499.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Total <span class=\"customMeta\" data-dictid=\"11b0cdbdbd1692777181cffbe7aa1b\">Anomalous</span> <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">Venous</span> Connection (TAPVC)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pulmonary veins drain into the right <span class=\"customMeta\" data-dictid=\"a8d33da8541692777182ec6983d9a2\">atrium</span> directly or indirectly via an <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> connection</li>\n<li>Not a ductal-dependent cyanotic lesion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sites of <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> connection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Supracardiac- superior <span class=\"customMeta\" data-dictid=\"3ddf6d5ea71692777201b70c8b9715\">vena</span> <span class=\"customMeta\" data-dictid=\"67544ba6ef16927771835d4641cc8f\">cava</span> (Most common)</li>\n<li>Cardiac-coronary sinus, right atrium</li>\n<li>Infracardiac</li>\n<li>Mixed</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cyanosis and congestive <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> failure</li>\n<li>With ASD- wide and split S2</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chest X-ray</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Snowman or figure-8 <span class=\"customMeta\" data-dictid=\"1792af7b92169277718423182d599d\">configuration</span> in supracardiac TAPVC</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Ian Bickle\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/snowman-sign-1\" data-tags=\"\" height=\"361\" src=\"https://image.prepladder.com/content/gs6hZkDRhtbFyExSyeUv1745412460.png\" width=\"361\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Surgery</li>\n<li>No indication for prostaglandins (Not a ductal-dependent cyanotic lesion)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Comment on the diagnosis of the CT chest shown below.", "options": [{"label": "A", "text": "Aortic dissection", "correct": true}, {"label": "B", "text": "Pulmonary embolism", "correct": false}, {"label": "C", "text": "Cardiac myxoma", "correct": false}, {"label": "D", "text": "Aortic aneurysm", "correct": false}], "correct_answer": "A. Aortic dissection", "question_images": ["https://image.prepladder.com/content/bcaHwQQKARLkAd2K2lT81748158578.png"], "explanation_images": ["https://image.prepladder.com/content/dHFfzqv3StIXZJFROjll1747128765.png", "https://image.prepladder.com/content/SCepFixrRNlYnw1Maq0G1748158595.png", "https://image.prepladder.com/content/KSJtXksWt1yMp3lCZWwd1748158622.png", "https://image.prepladder.com/content/BmKsT3FEFVY5xg9fErPx1748158666.png", "https://image.prepladder.com/content/CTaIrI494WjZBbZ5x90B1747128830.png", "https://image.prepladder.com/content/mgMzFp21kOgG03VkvvEW1748158688.png"], "explanation": "<p>Correct Answer A- A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55 year old male patient presented with complaints of dyspnea with congestive heart failure. The clinician wants to know whether it's HF with preserved EF or reduced EF. Which of the below investigation is used for calculation of ejection fraction?", "options": [{"label": "A", "text": "MUGA", "correct": true}, {"label": "B", "text": "SPECT using thallium", "correct": false}, {"label": "C", "text": "PET myocardial perfusion imaging", "correct": false}, {"label": "D", "text": "Sestamibi scan with pharmacological stress", "correct": false}], "correct_answer": "A. MUGA", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/m0OdpWD8xHzpmkbqMFWt1747129310.png"], "explanation": "<p>Correct Answer A- MUGA</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Purpose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Scan types</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>For Myocardial <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">Perfusion</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Assess ischemia</li>\n<li><strong>Cold spot: </strong>decreased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> in ischemic areas.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Thallium scan (Commonly used) <strong>(Option B)</strong></li>\n<li>Tetrofosmin</li>\n<li>Sestamibi scan <strong>(Option D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>For Myocardial Infarction </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Assess infarct</li>\n<li><strong>Hot spot</strong> in <span class=\"customMeta\" data-dictid=\"7d8fbc62391692777190399f2b0126\">infarct</span> area as <span class=\"customMeta\" data-dictid=\"53da8f40b5169277719620504e0cb9\">pyrophosphate</span> accumulates and is not metabolized.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>99m Tc - <span class=\"customMeta\" data-dictid=\"53da8f40b5169277719620504e0cb9\">Pyrophosphate</span> scan.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>For <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">Ventricular</span> Function </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Evaluate <span class=\"customMeta\" data-dictid=\"3b69bda4d21692777187109c85a27e\">ejection</span> fraction</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>MUGA</strong> (Multiple Gated Acquisition) scan (AKA nuclear ventriculography)\n\t\t\t\t<ul>\n<li>Radiolabeled RBCs are used</li>\n</ul>\n</li>\n<li>Most accurate for <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> function - <strong>Cardiac MRI</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>For Myocardial <span class=\"customMeta\" data-dictid=\"a8dece102f16927772026b199f06af\">Viability</span> </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Assess the <span class=\"customMeta\" data-dictid=\"a8dece102f16927772026b199f06af\">viability</span> of myocardium</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>PETscan </strong>- Best investigation for myocardial viability. <strong>(Option C)</strong>\n<ul>\n<li><strong>Perfusion</strong> and<strong> <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> mismatch</strong> are observed in the PET scan.</li>\n<li><strong>Perfusion Agents</strong>:N-13 <span class=\"customMeta\" data-dictid=\"edbc0adbb31692777181ed0ee792d4\">ammonia</span> and Rubidium chloride.</li>\n<li><strong>Metabolism Agent</strong>:</li>\n<li>FDG-PET is used for <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> metabolism.\n\t\t\t\t\t<ul>\n<li>No FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> indicates a <strong>normal heart</strong> or an<strong> infarct.</strong></li>\n<li>FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> is present: In the <strong>Ischemic Myocardium</strong></li>\n</ul>\n</li>\n<li>FDG-PET is combined with <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> for comprehensive assessment.\n\t\t\t\t\t<ul>\n<li>Uptake in PET with low <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> indicates <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> (suggestive of <strong>hibernation</strong>).</li>\n<li>Irreversible <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> indicates the presence of <strong>scar tissue</strong>.</li>\n</ul>\n</li>\n<li><strong>Note:</strong> Hibernating <span class=\"customMeta\" data-dictid=\"c64e23ddb8169277719344010b3fc0\">myocardium</span> is ischemic but viable.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 13 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 1-day-old newborn presents with respiratory distress. A chest X-ray is performed and is given below. Based on the findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Congenital Diaphragmatic Hernia", "correct": true}, {"label": "B", "text": "Esophageal atresia with tracheoesophageal fistula", "correct": false}, {"label": "C", "text": "Pulmonary sequestration", "correct": false}, {"label": "D", "text": "Congenital pulmonary airway malformation (CPAM)", "correct": false}], "correct_answer": "A. Congenital Diaphragmatic Hernia", "question_images": ["https://image.prepladder.com/notes/ZMctUPxJdbyxsp3veInX1744087458.png"], "explanation_images": ["https://image.prepladder.com/notes/ZMctUPxJdbyxsp3veInX1744087458.png", "https://image.prepladder.com/notes/fhoHFsogciEJS93RAzZi1744087459.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Fn5HOE1sylw7g6S1nmQQ1745340954.mp3", "video": ""}, {"text": "A term neonate presents with failure to pass meconium within the first 48 hours of life. Imaging shows a narrow distal bowel segment with proximal colonic dilatation. The Barium Enema image of the neonate is given below. What is the most likely condition affecting this neonate?", "options": [{"label": "A", "text": "Hirschsprung disease", "correct": true}, {"label": "B", "text": "Toxic megacolon", "correct": false}, {"label": "C", "text": "Crohn's disease", "correct": false}, {"label": "D", "text": "Ulcerative colitis", "correct": false}], "correct_answer": "A. Hirschsprung disease", "question_images": ["https://image.prepladder.com/notes/2EugENnNKauOYOoJzJT61744090775.png"], "explanation_images": ["https://image.prepladder.com/notes/YejXYfV4u3niJToz818g1744090776.png", "https://image.prepladder.com/notes/zFBN5y1DP3hXuPCCGw9H1744090776.png", "https://image.prepladder.com/notes/uOUqjHodvfBMCQT55JUS1744090777.png"], "explanation": "\n<p><strong>References:</strong></p>\n<ul><li>âł Hirschsprung-disease</li><li>âł Toxic megacolon | Radiology Reference Article | Radiopaedia.org</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old male presents with abdominal pain, weight loss, and chronic diarrhea. Radiologic studies reveal skip lesions in the ileum and cecum with a cobblestone appearance and deep ulcers. Which of the following radiologic signs is most consistent with this patient's diagnosis?", "options": [{"label": "A", "text": "Lead pipe colon", "correct": false}, {"label": "B", "text": "Collar button ulcers", "correct": false}, {"label": "C", "text": "String sign of Kantor", "correct": true}, {"label": "D", "text": "Loss of haustrations", "correct": false}], "correct_answer": "C. String sign of Kantor", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/bFxVK4YYQEZ39lm68ssr1744089559.png", "https://image.prepladder.com/notes/CvgS3sWXc7Wk3iVEo56w1744090772.png", "https://image.prepladder.com/notes/sEVCQ34WP0BdBnSkFvzd1744090773.png", "https://image.prepladder.com/notes/ZmomHI9KqcnrY3apsqJb1744090774.png", "https://image.prepladder.com/notes/y0bvYGaB28RAa2BHmM7y1744090774.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:781px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Crohnâs Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ulcerative Colitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Skip lesions</strong>; <span class=\"customMeta\" data-dictid=\"cb1eb1c704169277718933136caf06\">ileum</span> and <span class=\"customMeta\" data-dictid=\"603036123f1692777183f87e582e3e\">caecum</span> involved; <span class=\"customMeta\" data-dictid=\"9b9c4c412f1692777197ed217e7373\">rectum</span> relatively spared.</li>\n<li>Transmural; leads to ulceration, fissures, abscesses.</li>\n<li>Bowel wall may be affected asymmetrically with sacculations.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Continuous</strong> <span class=\"customMeta\" data-dictid=\"566fcef0991692777184068f36db82\">colonic</span> involvement; rectal in 95% of cases.</li>\n<li>Mucosal and submucosal; less severe.</li>\n<li>Fissure and <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> are not common.</li>\n<li>Circumferential <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> wall <span class=\"customMeta\" data-dictid=\"73e8d27894169277719960f922b4b5\">symmetry</span> is usually maintained.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. <span class=\"customMeta\" data-dictid=\"2e008d71301692777203aea7b2ae2a\">Fluoroscopy</span> (Barium Studies)</strong></p>\n<ul>\n<li>Mucosal abnormalities: Thickened, <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> folds and a<strong> \"cobblestone\" pattern</strong> due to a combination of <span class=\"customMeta\" data-dictid=\"7ba18aa5e616927771918a45051a40\">longitudinal</span> and <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> ulcers.</li>\n<li><strong>Aphthous ulcers: </strong>Appear as areas of <span class=\"customMeta\" data-dictid=\"55052c0f0616927771829c99eec183\">barium</span> collection within the swollen mucosa.</li>\n<li>Shows deep ulcers, <span class=\"customMeta\" data-dictid=\"cf1ebb699b16927772024941e0cdad\">fistulae</span> (e.g., enteroenteric, enterocolonic), and <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> tracts.</li>\n<li>Chronic disease features: Strictures, stenosis, and wall sacculations.</li>\n<li><strong>String sign of Kantor: </strong>A <span class=\"customMeta\" data-dictid=\"db8c3d4b9e1692777182a03a530a28\">beaded</span> string-like appearance due to <span class=\"customMeta\" data-dictid=\"225e0697ea1692777193892a2c34c7\">multifocal</span> <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> narrowing from strictures.</li>\n</ul>\n<p><strong>2. Ultrasonography</strong></p>\n<ul>\n<li>Concentric <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">mural</span> thickening of the <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> wall.</li>\n<li>Hyperemia within the inflamed segments.</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"90fde6a24316927771869acda3aa9c\">echogenicity</span> of surrounding fat.</li>\n</ul>\n<p><strong>3. CT and <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> Enterography</strong></p>\n<ul>\n<li>Asymmetric <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">Mural</span> thickening</li>\n<li>Ulcerations: Seen as air or contrast extending into the <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> wall.</li>\n<li>Strictures</li>\n<li>Mesenteric changes:\n\t\t\t\t<ul>\n<li><strong>Comb sign:</strong> <span class=\"customMeta\" data-dictid=\"02316c22e31692777187878aa0e0f7\">Engorgement</span> of the <span class=\"customMeta\" data-dictid=\"06595275c11692777201aee0394042\">vasa</span> recta.</li>\n<li>Mesenteric fat stranding, edema, and <span class=\"customMeta\" data-dictid=\"092583d1b41692777197a506409267\">reactive</span> adenopathy.</li>\n</ul>\n</li>\n<li>MRI-specific findings:\n\t\t\t\t<ul>\n<li><strong>T2 <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> </strong>signal: Indicates <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">mural</span> edema, best seen with fat-saturated sequences.</li>\n<li>Diffusion restriction: Suggestive of active inflammation.</li>\n<li>Active <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> shows hyperenhancement in arterial and post-contrast phases.</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. Radiographs</strong></p>\n<ul>\n<li>Bowel <span class=\"customMeta\" data-dictid=\"23b5d65f051692777195987380382d\">perforation</span> and toxic megacolon: Radiographs (upright and supine) help screen for these conditions.\n\t\t\t\t<ul>\n<li><strong>Toxic megacolon: </strong>Detected by <span class=\"customMeta\" data-dictid=\"566fcef0991692777184068f36db82\">colonic</span> distension &gt;6 cm, typically in the <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> colon.</li>\n</ul>\n</li>\n</ul>\n<img alt=\"-\" data-author=\"Hellerhoff\" data-hash=\"8140\" data-license=\"CC BY SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Toxic_Megacolon_in_Ulcerative_Colitis.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/bFxVK4YYQEZ39lm68ssr1744089559.png\"/>\n<p><strong>Fig. Toxic <span class=\"customMeta\" data-dictid=\"944688061e16927771929fa8717176\">megacolon</span> in <span class=\"customMeta\" data-dictid=\"b118cf61a016927772018a179057ef\">Ulcerative</span> colitis</strong></p>\n\t\t\t \n\n\t\t\t<ul>\n<li>Other findings: Air-fluid levels, loss of <span class=\"customMeta\" data-dictid=\"566fcef0991692777184068f36db82\">colonic</span> haustrations, mucosal islands, and absence of formed stool.</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>2. <span class=\"customMeta\" data-dictid=\"2e008d71301692777203aea7b2ae2a\">Fluoroscopy</span> (Barium Enema)</strong></p>\n<ul>\n<li>Mucosal abnormalities: <span class=\"customMeta\" data-dictid=\"4f63eb15be169277718848d4b4978b\">Granular</span> and <span class=\"customMeta\" data-dictid=\"3d7836b47f1692777199a5bbfc749f\">stippled</span> mucosa, with <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> erosions and ulcers.\n\t\t\t\t<ul>\n<li><strong>Collar button ulcers: </strong>Deeper ulcers extending into the submucosa. <strong>(Option B ruled out)</strong></li>\n<li>Pseudopolyps</li>\n</ul>\n</li>\n<li>Chronic disease features:\n\t\t\t\t<ul>\n<li><strong>Lead pipe colon:</strong> <span class=\"customMeta\" data-dictid=\"fbb10919e516927771917a9afcb633\">Luminal</span> narrowing and loss of haustrations in the colon. (Option A &amp; C ruled out)</li>\n<li><strong>Patulous <span class=\"customMeta\" data-dictid=\"6f7908953b1692777189fa3a1a9655\">ileocecal</span> <span class=\"customMeta\" data-dictid=\"416dd1004a169277720177d9a6adc5\">valve</span> (IC valve): </strong>With <span class=\"customMeta\" data-dictid=\"4f63eb15be169277718848d4b4978b\">granular</span> <span class=\"customMeta\" data-dictid=\"16b76d1d1c1692777200240efcb0e2\">terminal</span> ileum, indicative of <strong>backwash ileitis.</strong></li>\n</ul>\n</li>\n</ul>\n<p><strong>3. CT and <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> Enterography</strong></p>\n<ul>\n<li><strong>Active phase:</strong>\n<ul>\n<li>Mural hyperenhancement:</li>\n<li>Concentric <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">mural</span> thickening with stratification.</li>\n<li>Submucosal edema: Seen as T2 hyperintensity on MRI.</li>\n<li>Pseudopolyps</li>\n</ul>\n</li>\n<li><strong>Chronic phase:</strong>\n<ul>\n<li><strong>Lead pipe colon: </strong>Concentric <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">mural</span> thickening with <span class=\"customMeta\" data-dictid=\"fbb10919e516927771917a9afcb633\">luminal</span> narrowing and loss of haustrations.</li>\n<li>Submucosal fat deposition</li>\n<li>Presacral space widening due to <span class=\"customMeta\" data-dictid=\"9626003516169277719575ac559a91\">perirectal</span> fat.</li>\n<li>Post <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">Inflammatory</span> pseudopolyps</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Mohammad Niknejad\" data-hash=\"8141\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/comb-sign-in-active-crohn-disease\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/CvgS3sWXc7Wk3iVEo56w1744090772.png\"/>\n<p><strong>Comb Sign in active Crohnâs disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"p0\" data-author=\"Jeremy Jones\" data-hash=\"8143\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/lead-pipe-bowel#image-24800\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/sEVCQ34WP0BdBnSkFvzd1744090773.png\"/>\n<p><strong>Leadpipe appearance in <span class=\"customMeta\" data-dictid=\"b118cf61a016927772018a179057ef\">Ulcerative</span> colitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Mohammad Niknejad\" data-hash=\"8144\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/crohn-disease-with-string-sign-and-rectovaginal-fistula\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ZmomHI9KqcnrY3apsqJb1744090774.png\"/>\n<p><strong>String sign of Kantor and <span class=\"customMeta\" data-dictid=\"10c795db9e16927771973ce069fac8\">rectovaginal</span> fistula</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Maxime St-Amant\" data-hash=\"8145\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/inflammatory-pseudopolyps#image-2776983\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/y0bvYGaB28RAa2BHmM7y1744090774.png\"/>\n<p><strong>Inflammatory Pseudopolyps</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male presents to the emergency department with chronic abdominal pain, fever, and unintentional weight loss over the past month. He reports altered bowel habits and has a history of exposure to individuals with tuberculosis. A small bowel follow-through imaging is provided below. Based on the clinical presentation and the attached imaging, which of the following features is not typically seen in the patient?", "options": [{"label": "A", "text": "Spasm and edema at the ileocecal valve", "correct": false}, {"label": "B", "text": "Uniform thickening of the entire colon", "correct": true}, {"label": "C", "text": "Presence of mesenteric adenopathy", "correct": false}, {"label": "D", "text": "Stierlin Sign with rapid barium emptying", "correct": false}], "correct_answer": "B. Uniform thickening of the entire colon", "question_images": ["https://image.prepladder.com/notes/eZlsWBY4IvhCpDSFVZXu1744089558.png"], "explanation_images": ["https://image.prepladder.com/notes/1xfJCEMEXJddjdrjsl0p1744089558.png"], "explanation": "\n<p><strong>References:</strong></p>\n<ul><li>âł David Sutton Textbook of Radiology and Imaging, Volume 1, 8th edition, Page 2254- 2258</li><li>âł Ileocecal tuberculosis | Radiology Reference Article | Radiopaedia.org</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old female presents to the emergency department with severe abdominal pain, bloating, and vomiting. On examination, her abdomen is distended, and bowel sounds are decreased. A radiograph abdomen of the patient is given below. Which of the following is not a feature of the patientâs condition?", "options": [{"label": "A", "text": "Arises in the pelvis, specifically the left lower quadrant", "correct": false}, {"label": "B", "text": "Maintains a colonic haustral pattern", "correct": true}, {"label": "C", "text": "Causes whirlpool sign", "correct": false}, {"label": "D", "text": "Characterized by the coffee-bean sign", "correct": false}], "correct_answer": "B. Maintains a colonic haustral pattern", "question_images": ["https://image.prepladder.com/notes/TE7SAm3dnFYFwHaFpbiZ1744089557.png"], "explanation_images": ["https://image.prepladder.com/notes/TE7SAm3dnFYFwHaFpbiZ1744089557.png", "https://image.prepladder.com/notes/530meUQLHZ1WjfMrw4AR1744089557.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:750px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sigmoid Volvulus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Caecal Volvulus</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sigmoid <span class=\"customMeta\" data-dictid=\"061f9a880e1692777202e47dbb3d3f\">volvulus</span> arises in the pelvis, specifically the left lower quadrant. <strong>(Option A ruled out)</strong></li>\n<li>It extends towards the right upper quadrant.</li>\n<li>It has an <strong>ahaustral </strong>appearance (lack of haustra).</li>\n<li>Causes <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> of the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> large bowel, leading to <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">dilation</span> of the ascending, transverse, and <span class=\"customMeta\" data-dictid=\"0cf8ac70611692777186b133d027f6\">descending</span> colon.</li>\n<li>A few gas-fluid levels may be seen.</li>\n<li><strong>Coffee-Bean Sign</strong>: The condition is characterized by a distended <span class=\"customMeta\" data-dictid=\"9008060dc21692777198e329f5be75\">sigmoid</span> loop with an inverted U shape, known as the coffee-bean sign (or <strong>kidney bean sign</strong>). <strong>(Option D ruled out)</strong></li>\n<li><strong>Whirlpool Sign</strong>: The whirl, or whirlpool sign is observed when the <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> rotates around its mesentery, resulting in whirls of the mesenteric vessels. <strong>(Option C ruled out)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"49c306e91e1692777200be46fecf66\">torsion</span> is located in the <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> <span class=\"customMeta\" data-dictid=\"0fce15e71f1692777184feb9af5303\">colon</span> above the <span class=\"customMeta\" data-dictid=\"6f7908953b1692777189fa3a1a9655\">ileocecal</span> valve.</li>\n<li>Caecal <span class=\"customMeta\" data-dictid=\"061f9a880e1692777202e47dbb3d3f\">volvulus</span> arises in the right lower quadrant.</li>\n<li>It extends towards the <span class=\"customMeta\" data-dictid=\"b2332a96a2169277718756eb10e3e7\">epigastrium</span> or left upper quadrant.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"566fcef0991692777184068f36db82\">colonic</span> <strong>haustral </strong>pattern is maintained.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"0fce15e71f1692777184feb9af5303\">colon</span> is usually collapsed, and the small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> is distended.</li>\n<li>One gas-fluid level may be seen.</li>\n<li><strong>Definitive Sign</strong>: Upward <span class=\"customMeta\" data-dictid=\"5a50cd774d1692777186c56ec68eac\">displacement</span> of the <span class=\"customMeta\" data-dictid=\"b790a83bb41692777181cc3c0232af\">appendix</span> and <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> of the large <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> is a <span class=\"customMeta\" data-dictid=\"32b854324a1692777185c6c79fdc99\">definitive</span> sign of <span class=\"customMeta\" data-dictid=\"fca0acb15e169277718455018184a1\">cecal</span> volvulus.</li>\n<li>May show a U-shaped distended <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> segment and signs of ischemia, including <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">mural</span> thickening, <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> of the mesenteric fat, and <span class=\"customMeta\" data-dictid=\"8b4d9f2762169277719595156f1088\">pneumatosis</span> intestinalis.</li>\n<li><strong>Whirlpool Sign</strong>: A whirl sign may be apparent due to tight <span class=\"customMeta\" data-dictid=\"49c306e91e1692777200be46fecf66\">torsion</span> of the <span class=\"customMeta\" data-dictid=\"9f51fc9a741692777192ec164a061f\">mesentery</span> from a twist between the <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> and <span class=\"customMeta\" data-dictid=\"8833ce72c71692777187014d5585e7\">efferent</span> loops.</li>\n<li><strong>Coffee Bean Appearance</strong>: A \"coffee bean\" appearance may be seen in a loop of <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> colon.</li>\n<li><strong>Bird's <span class=\"customMeta\" data-dictid=\"273ed4fdf916927771827f19d7abc5\">Beak</span> Sign</strong>: Abrupt cut-off with âbird's beakâ tapering at the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"7e536c2543169277718488f0a5bb37\">cecum</span> is characteristic.</li>\n<li><strong>Central <span class=\"customMeta\" data-dictid=\"b790a83bb41692777181cc3c0232af\">appendix</span> sign</strong>: Abnormal <span class=\"customMeta\" data-dictid=\"b790a83bb41692777181cc3c0232af\">appendix</span> position near midline.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Mont4nha\" data-hash=\"8136\" data-license=\"CC0\" data-source=\"https://commons.wikimedia.org/wiki/File:Sigmoidvolvulus.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/TE7SAm3dnFYFwHaFpbiZ1744089557.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\" Ian Bickle\" data-hash=\"8137\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/caecal-volvulus-6#image-10240993\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/530meUQLHZ1WjfMrw4AR1744089557.png\"/></td>\n</tr>\n</tbody>\n\n<p><strong>References:</strong></p>\n<ul><li>âł Sigmoid volvulus vs cecal volvulus | Radiology Reference Article | Radiopaedia.org</li><li>âł Sigmoid Volvulus Imaging</li><li>âł Cecal Volvulus Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 7-year-old girl with a known history of lymphoma is brought to the emergency department for evaluation of severe abdominal pain and intermittent vomiting. Her parents report that she has recently passed currant jelly stools. On physical examination, a palpable abdominal mass is noted in the right upper quadrant. An abdominal ultrasound is given below. Based on the clinical presentation and the ultrasound findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute appendicitis", "correct": false}, {"label": "B", "text": "Intussusception", "correct": true}, {"label": "C", "text": "Sigmoid Volvulus", "correct": false}, {"label": "D", "text": "Cecal Volvulus", "correct": false}], "correct_answer": "B. Intussusception", "question_images": ["https://image.prepladder.com/notes/2jLAf5nIEAIeEqZMtJwp1744089555.png"], "explanation_images": ["https://image.prepladder.com/notes/35jQttNGRQdtatHDq3Sx1744089555.png", "https://image.prepladder.com/notes/bkx17w73cj6zab6A5peU1744089556.png", "https://image.prepladder.com/notes/VZI1oKU1eRyuq1p96ty61744089556.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male presents to the emergency department with severe abdominal pain, vomiting, and a distended abdomen. On examination, his bowel sounds are diminished. An abdominal radiograph is given below. What is the most likely diagnosis for this patient based on the given findings?", "options": [{"label": "A", "text": "Mesenteric ischemia", "correct": false}, {"label": "B", "text": "Small bowel obstruction", "correct": true}, {"label": "C", "text": "Acute gastroenteritis", "correct": false}, {"label": "D", "text": "Saline catharsis", "correct": false}], "correct_answer": "B. Small bowel obstruction", "question_images": ["https://image.prepladder.com/notes/ufj25Cul5avm5SIaKz1H1744089121.png"], "explanation_images": ["https://image.prepladder.com/notes/ufj25Cul5avm5SIaKz1H1744089121.png", "https://image.prepladder.com/notes/J2ZLZsRlqbo0FILObWsU1744089554.png"], "explanation": "\n<p><strong>References:</strong></p>\n<ul><li>âł String of pearls sign (gastrointestinal) | Radiology Reference Article</li><li>âł David Sutton Textbook of Radiology and Imaging, Volume 1, 8th edition, Page 2268</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male presents with colicky abdominal pain, distension, vomiting, and absolute constipation for the past 48 hours. He has a history of prior abdominal surgery. On physical examination, his abdomen is distended with high-pitched bowel sounds. An abdominal X-ray is obtained and shows the following features. What is the most likely diagnosis based on the clinical presentation and radiographic findings?", "options": [{"label": "A", "text": "Small bowel obstruction", "correct": true}, {"label": "B", "text": "Large bowel obstruction", "correct": false}, {"label": "C", "text": "Sigmoid volvulus", "correct": false}, {"label": "D", "text": "Paralytic ileus", "correct": false}], "correct_answer": "A. Small bowel obstruction", "question_images": ["https://image.prepladder.com/notes/czAC6yztL2gsFCuy6uwR1749097353.jpeg"], "explanation_images": ["https://image.prepladder.com/notes/NQtSekuqt7EyIvDYoxaI1744088611.png", "https://image.prepladder.com/notes/bBuJzp1N8QuZ6Lp6HQ7R1744088612.png", "https://image.prepladder.com/notes/CVBkBq9pxsR8dPesDyU11744088613.png", "https://image.prepladder.com/notes/pHpffXrI2QkkLbz5ortB1744088613.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:650px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Small Bowel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Large Bowel</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Number of loops</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Many loops visible</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Few loops visible</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Position of loops</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Central abdomen</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Peripheral (framing the small bowel)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Wall/Mucosal pattern</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Valvulae conniventes</strong> (complete <span class=\"customMeta\" data-dictid=\"0919f0017e1692777184ac3748841f\">circular</span> folds)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Haustra </strong>(incomplete bands)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diameter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;3 cm</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;6 cm (Caecum &gt;9 cm)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gas Pattern</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Multiple air-fluid levels, <strong>\"string of beads\"</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Distended colon, air-fluid levels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Igboeze\" data-hash=\"8126\" data-license=\"CC BY SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:1._Bowel-obstruction-x-ray.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/NQtSekuqt7EyIvDYoxaI1744088611.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"James Heilman\" data-hash=\"8127\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:LargeBowelObsFlat2008.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/bBuJzp1N8QuZ6Lp6HQ7R1744088612.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 1-day-old neonate presents with bilious vomiting and abdominal distension. An abdominal X-ray is performed and is given below. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Pyloric atresia", "correct": false}, {"label": "B", "text": "Duodenal atresia", "correct": false}, {"label": "C", "text": "Jejunal atresia", "correct": true}, {"label": "D", "text": "Ileal atresia", "correct": false}], "correct_answer": "C. Jejunal atresia", "question_images": ["https://image.prepladder.com/notes/qjcy0LacKaRbvyV8bMYL1744087459.png"], "explanation_images": ["https://image.prepladder.com/notes/iN9I7mzDzyMpkmePSSVV1744087459.png", "https://image.prepladder.com/notes/YXKEQ21aM6QuC1Xc0alF1744087460.png", "https://image.prepladder.com/notes/qyNBH16GTmPzyW7VDSU41744088611.png", "https://image.prepladder.com/notes/qjcy0LacKaRbvyV8bMYL1744087459.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:728px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Explanation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Normal Abdomen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Single bubble in the stomach</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A single air bubble seen in the left upper <span class=\"customMeta\" data-dictid=\"3a757d7c1216927771968223be411d\">quadrant</span> corresponds to the <span class=\"customMeta\" data-dictid=\"67492c42be16927772039f6e37110e\">fundus</span> of the stomach. A large single bubble is seen in cases of pyloric atresia, GOO.</p>\n<p><img alt=\"-\" data-author=\"Jeremy Jones\" data-hash=\"8122\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/normal-abdominal-x-ray-1\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/iN9I7mzDzyMpkmePSSVV1744087459.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pyloric <span class=\"customMeta\" data-dictid=\"5c10d19e4416927771829871a1737f\">Atresia</span> </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>\"Single bubble\" sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A single distended stomach with no air in the small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> or beyond, caused by <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> at the pylorus.</p>\n<img alt=\"-\" data-author=\"Samir,\" data-hash=\"8123\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:GOO_AXR.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/YXKEQ21aM6QuC1Xc0alF1744087460.png\"/><br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duodenal <span class=\"customMeta\" data-dictid=\"5c10d19e4416927771829871a1737f\">Atresia</span> </strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>\"Double bubble\" sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Distended stomach and <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> duodenum; no <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> gas due to <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> at the duodenum.</p>\n<p><img alt=\"-\" data-author=\"Pediatric Radiology Olgahospital Klinikum Stuttgart\" data-hash=\"8124\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:DuodAtres.png\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/qyNBH16GTmPzyW7VDSU41744088611.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Jejunal Atresia</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>\"Triple bubble\" sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Three distended loops of <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> (stomach, duodenum, <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> jejunum) with no <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> gas.</p>\n<p><img alt=\"-\" data-author=\"Hisham Alwakkaa\" data-hash=\"8121\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/jejunal-atresia-2#image-33384261\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/qjcy0LacKaRbvyV8bMYL1744087459.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ileal Atresia</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Multiple air-fluid levels</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dilated small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> loops with air-fluid levels and no gas in the large intestine, more <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> than jejunal atresia.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Q3nuzVVhCmCr1XvV3VDn1748940300.mp3", "video": ""}, {"text": "Match the following: Barium swallow a) 2.Barium meal b) 3.Barium follow through c) 4.Barium enema d)", "options": [{"label": "A", "text": "1-b, 2-d, 3-a, 4-c", "correct": false}, {"label": "B", "text": "1-c, 2-a, 3-d, 4-b", "correct": true}, {"label": "C", "text": "1-a, 2-c, 3-b, 4-d", "correct": false}, {"label": "D", "text": "1-b, 2-a, 3-d, 4-c", "correct": false}], "correct_answer": "B. 1-c, 2-a, 3-d, 4-b", "question_images": ["https://image.prepladder.com/notes/LtPdVec7F1IqaVg3l6YL1744085765.png", "https://image.prepladder.com/notes/oE93G5DUVXjxmLI2E5C61744085766.png", "https://image.prepladder.com/notes/kFUXv0FRg9RGRHoPMyhS1744085766.png", "https://image.prepladder.com/notes/b0ycsOzpmdupEO8zSRbf1744085766.png"], "explanation_images": ["https://image.prepladder.com/notes/kFUXv0FRg9RGRHoPMyhS1744085766.png", "https://image.prepladder.com/notes/LtPdVec7F1IqaVg3l6YL1744085765.png", "https://image.prepladder.com/notes/b0ycsOzpmdupEO8zSRbf1744085766.png", "https://image.prepladder.com/notes/oE93G5DUVXjxmLI2E5C61744085766.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:723px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium Studies</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium swallow</strong></p>\n<ul>\n<li>Test of the pharynx, esophagus, and <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> stomach</li>\n<li>Contraindicated in any GI perforation- <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">Esophageal</span> or intestinal and Tracheo-esophageal fistula</li>\n<li>There are three indentations in the <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">esophagus</span> :</li>\n<li>1st indentation- at the level of the Aortic Arch</li>\n<li>2nd indentation- at the level of Bronchus</li>\n<li>3rd indentation- at the level of the Left Atrium.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\" Ian Bickle\" data-hash=\"8096\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/normal-barium-swallow#image-30793391\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/kFUXv0FRg9RGRHoPMyhS1744085766.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium meal</strong></p>\n<p>Tests the esophagus, stomach, and <span class=\"customMeta\" data-dictid=\"280e59e9331692777186f3beac2c41\">duodenum</span> (the first part of the small intestine)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"\" data-hash=\"8094\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/LtPdVec7F1IqaVg3l6YL1744085765.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium follow through</strong></p>\n<ul>\n<li>Identify issues in the small <span class=\"customMeta\" data-dictid=\"7840cca3ed16927771901d2f6cb32b\">intestine</span> by <span class=\"customMeta\" data-dictid=\"ebb0986d331692777200ab09e1b2e8\">tracking</span> the passage of <span class=\"customMeta\" data-dictid=\"55052c0f0616927771829c99eec183\">barium</span> after ingestion.</li>\n<li>After drinking a <span class=\"customMeta\" data-dictid=\"55052c0f0616927771829c99eec183\">barium</span> liquid, there is a 10-15 minute wait before <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-rays</span> are taken every 30 minutes until the <span class=\"customMeta\" data-dictid=\"55052c0f0616927771829c99eec183\">barium</span> reaches the large intestine.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Subhan Iqbal\" data-hash=\"8097\" data-license=\"NA\" data-source=\" https://radiopaedia.org/articles/normal-oesophageal-contours-on-barium-swallow\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/b0ycsOzpmdupEO8zSRbf1744085766.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barium enema</strong></p>\n<ul>\n<li>Barium is given Transrectally.</li>\n<li>Double-contrast (Barium + Air)\n\t\t\t\t<ul>\n<li>Positive contrast - <span class=\"customMeta\" data-dictid=\"55052c0f0616927771829c99eec183\">Barium</span> (white)</li>\n<li>Negative contrast - Air (black)</li>\n</ul>\n</li>\n<li>Tests the pathologies of the large intestine- rectum, <span class=\"customMeta\" data-dictid=\"9008060dc21692777198e329f5be75\">sigmoid</span> <span class=\"customMeta\" data-dictid=\"0fce15e71f1692777184feb9af5303\">colon</span> and ascending, <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> and <span class=\"customMeta\" data-dictid=\"0cf8ac70611692777186b133d027f6\">descending</span> colon.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"\" data-hash=\"8095\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/oE93G5DUVXjxmLI2E5C61744085766.png\"/></td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/yO90LcYkrdXrPZJXdZCs1749046971.mp3", "video": ""}, {"text": "A 45-year-old woman presents with intermittent dysphagia to solids but not liquids. A barium swallow study is performed, as shown below. Which of the following is the most likely diagnosis based on the radiological findings?", "options": [{"label": "A", "text": "Schatzki ring", "correct": true}, {"label": "B", "text": "Plummer-Vinson syndrome", "correct": false}, {"label": "C", "text": "Diffuse esophageal spasm", "correct": false}, {"label": "D", "text": "Achalasia", "correct": false}], "correct_answer": "A. Schatzki ring", "question_images": ["https://image.prepladder.com/notes/iKO65v7HQdoeoP1EK6bb1744086617.png"], "explanation_images": ["https://image.prepladder.com/notes/iymyNgSOm9n152uXeW861744086618.png", "https://image.prepladder.com/notes/vxC7l5enUNrFfnIQy5Jm1744087456.png", "https://image.prepladder.com/notes/A7LKUcf1yzZuCWRiXrbW1744087457.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:749px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A Rings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>B Rings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C Rings</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Muscular rings</strong> formed due to <span class=\"customMeta\" data-dictid=\"3baac9012a1692777189cb4dc70c04\">hypertrophy</span> of smooth muscle <strong>in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> esophagus.</strong></li>\n<li>Covered in <span class=\"customMeta\" data-dictid=\"5be0ee4ea316927771997104326685\">squamous</span> epithelium.</li>\n<li>Transient and result from active muscle contraction.</li>\n<li>Asymptomatic and incidentally noted during esophagography.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lower <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> rings - fixed, <strong>mucosal rings</strong> located <strong>at the squamocolumnar junction.</strong></li>\n<li>Commonly found just above a hiatal hernia.</li>\n<li>Symptomatic B rings - <strong>Schatzki Rings</strong> (diameter &lt;13 mm) may cause dysphagia, especially when food passes through the narrowed area.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Located <strong>distal to the squamocolumnar junction.</strong></li>\n<li>Covered by <span class=\"customMeta\" data-dictid=\"5be0ee4ea316927771997104326685\">squamous</span> epithelium.</li>\n<li>Least common and asymptomatic.</li>\n<li>Represent <span class=\"customMeta\" data-dictid=\"06ff18f51216927771867fe1461a04\">diaphragmatic</span> <span class=\"customMeta\" data-dictid=\"cdb5523e491692777190f8bc3775ff\">indentation</span> of the esophagus</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/q6BrZCmX7Oiag9ajuoHw1749048497.mp3", "video": ""}, {"text": "A 55-year-old patient presents with intermittent chest pain and dysphagia. A barium swallow study is performed as part of the diagnostic workup. Which of the following radiographic findings is most characteristic of diffuse esophageal spasm (DES) as shown in the image?", "options": [{"label": "A", "text": "Bird-beak appearance of the distal esophagus", "correct": false}, {"label": "B", "text": "Corkscrew or rosary bead appearance of the esophagus", "correct": true}, {"label": "C", "text": "Smooth, tapered narrowing of the mid-esophagus", "correct": false}, {"label": "D", "text": "Saccular outpouchings along the entire length of the esophagus", "correct": false}], "correct_answer": "B. Corkscrew or rosary bead appearance of the esophagus", "question_images": ["https://image.prepladder.com/notes/qG4B6xzeG3OZDjDN8JWi1744086617.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:709px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiographic Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fluoroscopy (Barium Swallow)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>\"Corkscrew esophagus\" or \"rosary <span class=\"customMeta\" data-dictid=\"b65b938dfa16927771826d42406534\">bead</span> esophagus\"</li>\n<li>Non-peristaltic contractions pushing contrast in two directions</li>\n<li>Normal appearance possible</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>60% show abnormalities</li>\n<li><strong>&lt;5% show \"corkscrew esophagus\"</strong></li>\n<li>Non-peristaltic contractions may be the only feature in some cases</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Circumferential wall thickening of the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> 5 cm of the esophagus</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Seen in 20% of patients</li>\n<li>Wall thickening ranges from 5 to 15 mm</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Simultaneous contractions in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> esophagus</li>\n<li>Normal <span class=\"customMeta\" data-dictid=\"69d8ba3cb3169277719543eceaf072\">peristalsis</span> <span class=\"customMeta\" data-dictid=\"fb9eb5785916927771900fcb6718d4\">interrupted</span> by non-propulsive contractions</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Gold standard for diagnosis</strong></li>\n<li>Not strictly a radiographic modality, but included for completeness</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:735px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Esophageal <span class=\"customMeta\" data-dictid=\"c8c1db40c9169277719258df1a6b43\">Motility</span> Disorder</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>LES Resting Pressure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>LES Relaxation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Peristalsis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Contraction Amplitude</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Normal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>10-45 mmHg</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Complete <span class=\"customMeta\" data-dictid=\"5bc49d94df16927771975eae86de9f\">relaxation</span> occur i.e â¤8 mmHg)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Coordinated <span class=\"customMeta\" data-dictid=\"69d8ba3cb3169277719543eceaf072\">peristalsis</span> throughout</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Normal <span class=\"customMeta\" data-dictid=\"4c75de951316927771819cdfdbdd6a\">amplitude</span> is &lt;180 mmHg</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Achalasia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Elevated (&gt;45 mmHg)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Incomplete <span class=\"customMeta\" data-dictid=\"5bc49d94df16927771975eae86de9f\">relaxation</span> (&gt;8 mmHg)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Absent in the <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> body</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>N/A</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Diffuse <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">Esophageal</span> <span class=\"customMeta\" data-dictid=\"0338b655da16927771984b872baabb\">Spasm</span> (DES)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Normal (â¤45 mmHg)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Normal (â¤8 mmHg)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Uncoordinated in &gt;20% of swallows</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Often high (&gt;180 mmHg) in <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> esophagus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Nutcracker <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">Esophagus</span> (Jackhammer Esophagus)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Normal (â¤45 mmHg)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Normal (â¤8 mmHg)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Normal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Very high (&gt;220 mmHg)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old patient presents with progressive dysphagia, initially for solids and later for liquids. A barium swallow study is performed, and two different radiographic findings are shown below. Which of the following statements correctly differentiates between these images?", "options": [{"label": "A", "text": "Image 1 shows achalasia cardia with a \"bird beak\" sign, while Image 2 shows carcinoma esophagus with irregular narrowing", "correct": true}, {"label": "B", "text": "Image 1 shows carcinoma esophagus with smooth narrowing, while Image 2 shows achalasia cardia", "correct": false}, {"label": "C", "text": "Both images show achalasia cardia", "correct": false}, {"label": "D", "text": "Both images show carcinoma esophagus affecting different parts of the esophagus", "correct": false}], "correct_answer": "A. Image 1 shows achalasia cardia with a \"bird beak\" sign, while Image 2 shows carcinoma esophagus with irregular narrowing", "question_images": ["https://image.prepladder.com/notes/5aOTl8fzgxVTRX7aFGMJ1744086616.png", "https://image.prepladder.com/notes/xZqt7euoT3x3cY6TRC3L1744086616.png"], "explanation_images": ["https://image.prepladder.com/notes/dpIFYf6ME2XfgXD3vzop1744086617.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:703px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Achalasia <span class=\"customMeta\" data-dictid=\"adc19c4a9b16927771836b8115874d\">Cardia</span> (Image 1) </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carcinoma <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">Esophagus</span> (Image 2) </strong><strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Esophageal Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Massively dilated esophagus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irregular narrowing of esophagus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Distal <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">Esophagus</span> </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Narrow lower end (\"bird beak\" sign)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Malignant stricture</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Affects lower <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> sphincter</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mid-esophagus in this case</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contour</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Smooth tapering at <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> end</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irregular, abrupt narrowing</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Additional Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Proximal <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">esophagus</span> is dilated</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>May show shouldering or \"apple core\" appearance (not visible in this image)</p>\n<p><img alt=\"-\" data-author=\"Roberto Rafael Ovalle\" data-hash=\"8110\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/apple-core-sign\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/dpIFYf6ME2XfgXD3vzop1744086617.png\"/><br/>\n<strong>Fig. Apple core appearance</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fWBU0brzH8Wb5mDwzpeS1749047943.mp3", "video": ""}, {"text": "A 72-year-old man presents with dysphagia, regurgitation, and halitosis. A barium swallow examination is performed which is given below. Which of the following radiological findings is most consistent with the presentation?", "options": [{"label": "A", "text": "An outpouching arising from the anterior wall of the proximal esophagus", "correct": false}, {"label": "B", "text": "Multiple small diverticula along the length of the esophagus", "correct": false}, {"label": "C", "text": "A diverticulum arising from the midline of the posterior wall of the distal pharynx", "correct": true}, {"label": "D", "text": "A smooth narrowing of the distal esophagus", "correct": false}], "correct_answer": "C. A diverticulum arising from the midline of the posterior wall of the distal pharynx", "question_images": ["https://image.prepladder.com/notes/RMZlJRGe20udE0BZvA0f1744086615.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:672px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Findings</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Barium Swallow (Fluoroscopy)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diverticulum arising from the midline of the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> wall of the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> pharynx</li>\n<li>Located near the <span class=\"customMeta\" data-dictid=\"0d9ab8e31b169277719584687d421a\">pharyngoesophageal</span> junction</li>\n<li>Best identified during swallowing</li>\n<li>Best seen on <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> view</li>\n<li>Typically noted at the C5-6 level</li>\n<li>May be <span class=\"customMeta\" data-dictid=\"a6cf2c3dc51692777200ef7fb22f69\">transient</span> (referred to as a \"pharyngeal pouch\")</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Additional Findings</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>~90% of patients also show a hiatal <span class=\"customMeta\" data-dictid=\"9cf1b2a8bc16927771899480554f5a\">hernia</span> and gastro-esophageal reflux</li>\n<li>The distended <span class=\"customMeta\" data-dictid=\"59ae5630de16927771988a866d1dea\">sac</span> may <span class=\"customMeta\" data-dictid=\"c6486470671692777184e25019e1f0\">compress</span> the <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">cervical</span> esophagus</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 58-year-old man presents to the emergency department with acute onset of severe abdominal pain and distension. An abdominal X-ray is performed, showing free air in the peritoneal cavity. Which of the following signs represents free air outlining the lateral umbilical ligaments?", "options": [{"label": "A", "text": "Ligamentum sign", "correct": false}, {"label": "B", "text": "Inverted V sign", "correct": true}, {"label": "C", "text": "Telltale triangle sign", "correct": false}, {"label": "D", "text": "Doge cap sign", "correct": false}], "correct_answer": "B. Inverted V sign", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:685px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decubitus <span class=\"customMeta\" data-dictid=\"ac388c59831692777180f5a8e12913\">abdomen</span> sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Free air between the <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> wall and the liver on left <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"f518295be51692777185698bd9b0fd\">decubitus</span> view</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ligament sign (Falciform <span class=\"customMeta\" data-dictid=\"301e3b01f01692777191aced6dc342\">ligament</span> sign) <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Visualization of the <span class=\"customMeta\" data-dictid=\"4495d21f7716927772028e313cdedc\">falciform</span> <span class=\"customMeta\" data-dictid=\"301e3b01f01692777191aced6dc342\">ligament</span> due to free air on both sides</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inverted V sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Air surrounding the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"9cc3973459169277720194a0847477\">umbilical</span> ligaments</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Telltale sign (Triangle sign) <strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Triangular accumulation of air between <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> loops</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Doge cap sign <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Air in Morrison's/hepatorenal pouch</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 72-year-old woman presents to the emergency department with sudden onset of severe abdominal pain and distension. An upright chest X-ray is performed, showing the following finding: Which of the following is the most likely diagnosis based on this radiographic finding?", "options": [{"label": "A", "text": "Bowel obstruction", "correct": false}, {"label": "B", "text": "Pneumoperitoneum", "correct": true}, {"label": "C", "text": "Subphrenic abscess", "correct": false}, {"label": "D", "text": "Pneumatosis intestinalis", "correct": false}], "correct_answer": "B. Pneumoperitoneum", "question_images": ["https://image.prepladder.com/notes/QwzSobWNzdjWUmr0r4m21744085768.png"], "explanation_images": ["https://image.prepladder.com/notes/BTxOSOEDDOnFMuvjS5LC1744085768.png", "https://image.prepladder.com/notes/RHLx8PNtpe1S61ayGEvz1744086614.png", "https://image.prepladder.com/notes/pScqLRhZNKrenkGAEATg1744086615.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:707px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Findings of Pneumoperitoneum</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Upright Chest X-ray</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Subdiaphragmatic free gas</li>\n<li>Continuous <span class=\"customMeta\" data-dictid=\"5b42867b61169277718692205c2447\">diaphragm</span> sign</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Supine <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">Abdominal</span> X-ray</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Rigler's sign </strong>(gas within the bowel's <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> and gas within the peritoneal cavity)</li>\n<li><strong>Cupola sign </strong>(air beneath the <span class=\"customMeta\" data-dictid=\"48872daf681692777186072f36702a\">dome</span> of diaphragm)</li>\n<li><strong>Football sign</strong> (oval-shaped collection of air in the upper abdomen)</li>\n<li>Triangular air collection in Morrison's pouch</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CT Scan</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Free air in the peritoneal cavity</li>\n<li>Air outlining <span class=\"customMeta\" data-dictid=\"b02812a466169277719090c2d27868\">intra-abdominal</span> organs</li>\n<li>Air trapped between <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> loops</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ultrasound</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Enhanced peritoneal <span class=\"customMeta\" data-dictid=\"46eb4a312d169277719950b549eca4\">stripe</span> sign</li>\n<li>Shifting phenomenon (movement of air with patient positioning)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old man presents with sudden, severe abdominal pain and a rigid abdomen. He has a history of peptic ulcer disease. An erect chest X-ray is given below. Which of the following radiological signs is NOT expected in this case?", "options": [{"label": "A", "text": "Cupola sign", "correct": false}, {"label": "B", "text": "Riglerâs sign", "correct": false}, {"label": "C", "text": "Free gas under the right hemidiaphragm", "correct": false}, {"label": "D", "text": "Chilaiditi sign", "correct": true}], "correct_answer": "D. Chilaiditi sign", "question_images": ["https://image.prepladder.com/notes/KWbY2YF1eml0WMLrj1GX1744085767.png"], "explanation_images": ["https://image.prepladder.com/notes/nG3v64CmAZaaOqsJzBJm1744085768.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A newborn is diagnosed with an anorectal malformation (imperforate anus) on physical examination. Given the high association with VACTERL anomalies, the medical team decides to conduct a series of radiographic studies to assess for potential associated conditions. Which of the following is a key imaging modality in the evaluation of a neonate with imperforate anus?", "options": [{"label": "A", "text": "Plain abdominal X-ray", "correct": false}, {"label": "B", "text": "Invertogram", "correct": true}, {"label": "C", "text": "Abdominal ultrasound", "correct": false}, {"label": "D", "text": "Distal colostogram", "correct": false}], "correct_answer": "B. Invertogram", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/JHuvyw4Ix2cgpaj8yTGX1744085767.png"], "explanation": "\n<p><strong>References:</strong></p>\n<ul><li>âł Anorectal Malformations - StatPearls - NCBI Bookshelf</li><li>âł Imperforate Anus - StatPearls - NCBI Bookshelf (nih.gov)</li><li>âł Pediatric abdomen (invertogram view) | Radiology Reference Article | Radiopaedia.org</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 28 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following is a primary use of this imaging modality?", "options": [{"label": "A", "text": "Staging of esophageal cancer", "correct": true}, {"label": "B", "text": "Evaluation of gastroesophageal reflux disease (GERD)", "correct": false}, {"label": "C", "text": "Identifying the cause of dysphagia", "correct": false}, {"label": "D", "text": "Assessing cardiac and aortic pathology", "correct": false}], "correct_answer": "A. Staging of esophageal cancer", "question_images": ["https://image.prepladder.com/content/dX6ygIOTIo4YCuad18YV1741087794.png"], "explanation_images": ["https://image.prepladder.com/content/df3MKhXZiv3Sqfwa7TMC1741087906.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Application</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Primary Use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Staging of <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> cancer</strong> (Correct Answer)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Evaluates tumor depth and <span class=\"customMeta\" data-dictid=\"4df97a6cbf169277719172fd1af767\">lymph</span> <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">node</span> involvement</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pancreatic lesions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Detects and biopsies pancreatic cysts, tumors, or chronic pancreatitis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subepithelial GI tumors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Differentiates between leiomyomas, GISTs, and <span class=\"customMeta\" data-dictid=\"7eca2476201692777193e0a0959bd7\">neuroendocrine</span> tumors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Biliary pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Detects <span class=\"customMeta\" data-dictid=\"92128a6d941692777184f9d2f7ef4d\">choledocholithiasis</span> and <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> strictures</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rectal cancer staging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Determines depth of invasion and <span class=\"customMeta\" data-dictid=\"4df97a6cbf169277719172fd1af767\">lymph</span> <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">node</span> involvement</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following images accurately represents the medical condition described in the given scenario?", "options": [{"label": "A", "text": "Diaphragmatic hernia", "correct": true}, {"label": "B", "text": "Intestinal obstruction", "correct": false}, {"label": "C", "text": "Pleural effusion", "correct": false}, {"label": "D", "text": "Pneumonia", "correct": false}], "correct_answer": "A. Diaphragmatic hernia", "question_images": ["https://image.prepladder.com/content/9KLSwZPumxHhyVTiA2ou1747129710.png"], "explanation_images": ["https://image.prepladder.com/content/XbxuC4jlZoUbbOUy4MX31747129747.png"], "explanation": "<p>Correct Answer A- &lt;span class=\"customMeta\" data-dictid=\"06ff18f51216927771867fe1461a04\"&gt;Diaphragmatic&lt;/span&gt; h\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 51-year-old man complains of abdominal pain and blood-stained stools. The X ray of his intestines shows the following finding. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Intussusception", "correct": true}, {"label": "B", "text": "Volvulus", "correct": false}, {"label": "C", "text": "Diverticulitis", "correct": false}, {"label": "D", "text": "Ulcerative colitis", "correct": false}], "correct_answer": "A. Intussusception", "question_images": ["https://image.prepladder.com/content/5VhBMPQsdMrS6gACdivu1746700543.png"], "explanation_images": ["https://image.prepladder.com/content/BiInZkbJLF25mzqlVEvn1746700605.png", "https://image.prepladder.com/content/TTb8JOoZF4iJwxVoaUx71746700629.png", "https://image.prepladder.com/content/kbzWfVi3RbLGjxlfFeBZ1746700643.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely diagnosis for a 20-year-old male who presents with pain in the right flank, along with fever and chills? The patient experiences pain when the hip is passively extended on the right side. Lab tests indicate an increased white blood cell count, and a CT scan reveals specific findings.", "options": [{"label": "A", "text": "Pyelonephritis", "correct": false}, {"label": "B", "text": "Psoas abscess", "correct": true}, {"label": "C", "text": "Appendicitis", "correct": false}, {"label": "D", "text": "Torsion of right undescended testis", "correct": false}], "correct_answer": "B. Psoas abscess", "question_images": ["https://image.prepladder.com/notes/kaTnKWDI5ge86ENNHYdz1747997653.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 51-year-old man complains of abdominal pain and blood-stained stools. The barium study of his intestines shows the following finding. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Intussusception", "correct": true}, {"label": "B", "text": "Volvulus", "correct": false}, {"label": "C", "text": "Diverticulitis", "correct": false}, {"label": "D", "text": "Ulcerative colitis", "correct": false}], "correct_answer": "A. Intussusception", "question_images": ["https://image.prepladder.com/notes/WBYjDs0kHqOh0fnOlLJ51746433301.png"], "explanation_images": ["https://image.prepladder.com/content/2xowDBk5ZrIAaDhyyLZn1745237124.png", "https://image.prepladder.com/notes/x39NuqWDcBJIN2RZIY1r1746433382.png", "https://image.prepladder.com/content/TGBwlgLQxiOv6Ra59zZP1745237138.png", "https://image.prepladder.com/content/luAxumJadvxuKtOQhGj51745237148.png", "https://image.prepladder.com/content/FbYLmzgvDoymkZSd2TXF1745237156.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 56-year-old female patient presented with progressive dysphagia for solids, loss of weight, and loss of appetite. A barium swallow done is given below. What is the most probable diagnosis", "options": [{"label": "A", "text": "Carcinoma esophagus", "correct": true}, {"label": "B", "text": "Diffuse esophageal spasm", "correct": false}, {"label": "C", "text": "Esophageal leiomyoma", "correct": false}, {"label": "D", "text": "Esophageal web", "correct": false}], "correct_answer": "A. Carcinoma esophagus", "question_images": ["https://image.prepladder.com/content/XGG7nOzSNH8X0FABjybS1745236738.png"], "explanation_images": ["https://image.prepladder.com/content/edfNZMkQGqaI3WSh32Vj1745236861.png", "https://image.prepladder.com/notes/b2oUfgkXb5Y7ycYb0cSV1746433113.png", "https://image.prepladder.com/content/FpyFf0ZyXVTnZp6kCwX51745236877.png", "https://image.prepladder.com/content/UNYaDjkOLvvFxVUYvMW21745236884.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Achalasia <span class=\"customMeta\" data-dictid=\"adc19c4a9b16927771836b8115874d\">Cardia</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Carcinoma Esophagus</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Esophageal Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Massively dilated esophagus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irregular narrowing of esophagus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Distal <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">Esophagus</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Narrow lower end (\"bird beak\" sign)</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"https://prod-images-static.radiopaedia.org/images/57346336/0._big_gallery.jpeg\" data-tags=\"\" height=\"732\" src=\"https://image.prepladder.com/content/edfNZMkQGqaI3WSh32Vj1745236861.png\" width=\"386\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Malignant stricture</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Affects lower <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> sphincter</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mid-esophagus in this case</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contour</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Smooth tapering at <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> end</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irregular, abrupt narrowing</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Additional Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Proximal <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">esophagus</span> is dilated</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>May show shouldering or \"apple core\" appearance (not visible in this image)</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA856\" data-author=\"Roberto Rafael Ovalle\" data-hash=\"11801\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/apple-core-sign\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/b2oUfgkXb5Y7ycYb0cSV1746433113.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p><br/>\n<strong>Fig. Apple core appearance</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the options below represents a characteristic observed in cases of large bowel obstruction?", "options": [{"label": "A", "text": "Dilated loops of the intestine with plica circulars", "correct": false}, {"label": "B", "text": "Dilated loops with haustrations", "correct": true}, {"label": "C", "text": "String of pearls sign", "correct": false}, {"label": "D", "text": "Central dilated bowel loops", "correct": false}], "correct_answer": "B. Dilated loops with haustrations", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/dLSL7hZOGJa4KztFgFXQ1745491907.png", "https://image.prepladder.com/content/Z1WkAq7SwWKbPNEryl861745491911.png", "https://image.prepladder.com/content/DE1sdoNAvYwSqvmhZW991745491928.png", "https://image.prepladder.com/content/E3LjzoZdpFkngGuiIfoS1745491932.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">Bowel</span> <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">Obstruction</span> (SBO)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Large <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">Bowel</span> <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">Obstruction</span> (LBO)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Dilated loops</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Central, thin-walled</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Peripheral, thick-walled</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Folds</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Plica circulares (valvulae conniventes)</p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Hellerhoff\" data-hash=\"\" data-license=\"CC BY-SA 3.0\" data-source=\"File:Duenndarmileus Chiasamen - Roe - 0001 - Annotation.jpg - Wikimedia Commons\" data-tags=\"\" height=\"316\" src=\"https://image.prepladder.com/content/dLSL7hZOGJa4KztFgFXQ1745491907.png\" width=\"309\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Haustrations (do not extend completely across the lumen)</p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"James Heilman, MD\" data-hash=\"\" data-license=\"CC BY-SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:LargeBowelObsFlat2008.jpg\" data-tags=\"\" height=\"365\" src=\"https://image.prepladder.com/content/Z1WkAq7SwWKbPNEryl861745491911.png\" width=\"417\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>\"String of pearls\" sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Yes (air-fluid levels in SBO)</p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Sajoscha A. Sorrentino\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/small-bowel-obstruction-string-of-pearls-sign-8#image-1446960\" data-tags=\"\" height=\"238\" src=\"https://image.prepladder.com/content/DE1sdoNAvYwSqvmhZW991745491928.png\" width=\"327\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<p><strong>String of <span class=\"customMeta\" data-dictid=\"0707c047ba1692777195ce682d9eca\">pearl</span> appearance</strong></p>\n<p> </p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"James Heilman, MD\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Upright_abdominal_X-ray_demonstrating_a_bowel_obstruction.jpg\" data-tags=\"\" height=\"306\" src=\"https://image.prepladder.com/content/E3LjzoZdpFkngGuiIfoS1745491932.png\" width=\"327\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>No</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Transition point</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Small bowel</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Colon or <span class=\"customMeta\" data-dictid=\"d54167c73316927771970038452d57\">rectosigmoid</span> region</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with abdominal pain and distension. An X-ray was taken which showed dilated bowel loops as given in the image below. Identify the segment involved.", "options": [{"label": "A", "text": "Jejunum", "correct": true}, {"label": "B", "text": "Ileum", "correct": false}, {"label": "C", "text": "Duodenum", "correct": false}, {"label": "D", "text": "Transverse colon", "correct": false}], "correct_answer": "A. Jejunum", "question_images": ["https://image.prepladder.com/notes/99BzGrO2WOSr4wWZShsN1746445432.png"], "explanation_images": ["https://image.prepladder.com/notes/W6nt1sROfWemcsePKeDv1746445466.png", "https://image.prepladder.com/content/2SPJKMYcRZvYUO1TGZQ61745413357.png", "https://image.prepladder.com/notes/8vjV7K5VIXWIAv0t3qcA1746445666.png", "https://image.prepladder.com/content/P9XlA2JI8uMqHi7aUfs31745413631.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Jejunum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Plicae circulares or <span class=\"customMeta\" data-dictid=\"775b64181b1692777201c6ab88b10e\">valvulae</span> conniventes</strong></p>\n<ul>\n<li>Visible as circumferential, ring-like patterns.</li>\n<li>Multiple dilated <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> loops.</li>\n<li>Loops are centrally located.</li>\n<li>The mucosal pattern appears well-defined with a âfeatheryâ appearance due to the <span class=\"customMeta\" data-dictid=\"33864cf9a5169277719571e0fdfb61\">plicae</span> circulares.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ileum</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dilated <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> loops.</strong></p>\n<ul>\n<li>Loops are centrally located.</li>\n<li>Featureless or âcharacteristically characterlessâ appearance, lacking the pronounced mucosal pattern seen in the jejunum.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient following a skid resulting in a motor traffic accident was brought to the emergency room 2 hours later. On examination, he was stable with GCS 15/15. The pupil was reactive to light. Tenderness and bruising over the left lower chest wall with petechiae were seen. Severe tenderness was elicited in the left hypochondriac region and BP-90/50 mm of Hg. What is the best investigation used in the ER? GCS: Glasgow coma scale FAST: Focused Assessment with Sonography for Trauma", "options": [{"label": "A", "text": "FAST", "correct": true}, {"label": "B", "text": "X-ray", "correct": false}, {"label": "C", "text": "Diagnostic peritoneal lavage", "correct": false}, {"label": "D", "text": "CT scan", "correct": false}], "correct_answer": "A. FAST", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/muYdZpo3r64ZdFWR6UHQ1745412904.png", "https://image.prepladder.com/notes/Odcipis6eBljnXyy1Mps1746445168.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the diagnosis of a young child who is experiencing mild intermittent upper abdominal pain and has an X-ray shown below?", "options": [{"label": "A", "text": "Bochdalek hernia", "correct": false}, {"label": "B", "text": "Morgagni hernia", "correct": true}, {"label": "C", "text": "Gastric volvulus", "correct": false}, {"label": "D", "text": "Eventration of diaphragm", "correct": false}], "correct_answer": "B. Morgagni hernia", "question_images": ["https://image.prepladder.com/notes/Ht6SrtNuhOeqICpM6SaI1747112374.png"], "explanation_images": ["https://image.prepladder.com/notes/Rx93UYFYtZhLOlwz9y491746438885.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old patient presented with vague abdominal pain. What is the diagnosis?", "options": [{"label": "A", "text": "RCC", "correct": false}, {"label": "B", "text": "Renal oncocytoma", "correct": false}, {"label": "C", "text": "Renal Angiomyolipoma", "correct": true}, {"label": "D", "text": "Renal cyst", "correct": false}], "correct_answer": "C. Renal Angiomyolipoma", "question_images": ["https://image.prepladder.com/notes/bHiZa6M9fOGmJ9B3ikMW1747112097.png"], "explanation_images": ["https://image.prepladder.com/notes/Zj0rXl2A1OfFyQLRzlOc1746436277.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with abdominal pain and distension. An x-ray was taken which showed dilated bowel loops as given in the image below. Identify the segment involved.", "options": [{"label": "A", "text": "Jejunum", "correct": true}, {"label": "B", "text": "Ileum", "correct": false}, {"label": "C", "text": "Duodenum", "correct": false}, {"label": "D", "text": "Transverse colon", "correct": false}], "correct_answer": "A. Jejunum", "question_images": ["https://image.prepladder.com/content/oySy6WgR07r2Kuzy6GZj1747909771.png"], "explanation_images": ["https://image.prepladder.com/content/bxrBjifLiVkA2mfN0RfF1747909784.png", "https://image.prepladder.com/content/kIGwDXUazZXOegTPZ68R1747909794.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Segment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Radiological Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Jejunum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><em>Valvulae conniventes</em> (plicae circulares) seen throughout the bowel, giving a <strong>stacked coin</strong> or <strong>coiled spring</strong> appearance.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ileum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Less prominent <span class=\"customMeta\" data-dictid=\"775b64181b1692777201c6ab88b10e\">valvulae</span> conniventes, <strong>fewer folds</strong>, and a <strong>featureless</strong> appearance compared to the jejunum.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Duodenum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dilated <span class=\"customMeta\" data-dictid=\"280e59e9331692777186f3beac2c41\">duodenum</span> in <strong>proximal obstruction</strong>, \"double bubble\" sign in <strong>duodenal atresia</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Transverse Colon</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Haustral markings</strong> (do not completely cross the lumen), <strong>wider spacing</strong> than jejunal folds.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:650px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Small Bowel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Large Bowel</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Number of loops</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Many loops visible</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Few loops visible</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Position of loops</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Central abdomen</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Peripheral (framing the small bowel)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Wall/Mucosal pattern</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Valvulae conniventes</strong> (complete <span class=\"customMeta\" data-dictid=\"0919f0017e1692777184ac3748841f\">circular</span> folds)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Haustra </strong>(incomplete bands)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diameter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>&gt;3 cm</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>&gt;6 cm (Caecum &gt;9 cm)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Gas Pattern</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Multiple air-fluid levels, <strong>\"string of beads\"</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Distended colon, air-fluid levels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"James Heilman, MD\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Upright_abdominal_X-ray_demonstrating_a_bowel_obstruction.jpg\" data-tags=\"\" height=\"4047\" src=\"https://image.prepladder.com/content/bxrBjifLiVkA2mfN0RfF1747909784.png\" width=\"4167\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"James Heilman, MD\" data-hash=\"\" data-license=\"CC BY-SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:LargeBowelObsFlat2008.jpg\" data-tags=\"\" height=\"3634\" src=\"https://image.prepladder.com/content/kIGwDXUazZXOegTPZ68R1747909794.png\" width=\"4167\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the investigation shown below which is the investigation of choice in distal bowel tumors.", "options": [{"label": "A", "text": "Enteroclysis", "correct": false}, {"label": "B", "text": "Barium meal", "correct": false}, {"label": "C", "text": "Barium meal follow-through", "correct": false}, {"label": "D", "text": "Barium enema", "correct": true}], "correct_answer": "D. Barium enema", "question_images": ["https://image.prepladder.com/notes/Z0ypXkNEmaUgCIXyy8Mj1747722478.png"], "explanation_images": ["https://image.prepladder.com/content/9yhfAOkWgffArkHYPxqT1745921507.png", "https://image.prepladder.com/content/VAy8K8llsn2M9bRGeK4I1745921507.png", "https://image.prepladder.com/notes/bCAyPHJCB8GKOHwMfOb01747911688.png", "https://image.prepladder.com/content/KXqaWJVwdvkrEz0Qx0Tc1745921507.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Investigation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Indication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Best for</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Barium Swallow</strong></p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Subhan Iqbal \" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/normal-oesophageal-contours-on-barium-swallow\" data-tags=\"\" height=\"336\" src=\"https://image.prepladder.com/content/9yhfAOkWgffArkHYPxqT1745921507.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Oropharyngeal and <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> disorders</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Esophageal stricture, achalasia, tumors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Barium Meal</strong></p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Seneviratne SA, Samarasekera DN\" data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://openi.nlm.nih.gov/detailedresult?img=PMC2740091_1757-1626-0002-0000006710-001&amp;query=barium%20meal&amp;it=xg&amp;req=4&amp;npos=13\" data-tags=\"\" height=\"178\" src=\"https://image.prepladder.com/content/VAy8K8llsn2M9bRGeK4I1745921507.png\" width=\"235\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Upper GI <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> evaluation (stomach, duodenum)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Peptic <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> disease, <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> tumors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Barium Meal Follow-through</strong></p>\n<figure class=\"caption_element\"><img alt=\" Barium Meal Follow through\" data-author=\" Glitzy queen00\" data-hash=\"13173\" data-license=\"Open access\" data-source=\"https://commons.wikimedia.org/wiki/File:Smallbowel.jpg\" data-tags=\"May2025\" height=\"300\" src=\"https://image.prepladder.com/notes/bCAyPHJCB8GKOHwMfOb01747911688.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> imaging</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Crohnâs disease, <span class=\"customMeta\" data-dictid=\"819ebcc6691692777191f968d41a03\">malabsorption</span> syndromes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Enteroclysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Detailed small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> study</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Subtle small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> lesions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Barium Enema</strong></p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Kim JS, Lee BI, Kim BW, Choi H, Lee YS, Maeng L\" data-hash=\"\" data-license=\"CC BY-NC 3.0\" data-source=\"https://openi.nlm.nih.gov/detailedresult?img=PMC3797951_ce-46-591-g001&amp;query=barium%20enema&amp;it=xg&amp;req=4&amp;npos=69\" data-tags=\"\" height=\"240\" src=\"https://image.prepladder.com/content/KXqaWJVwdvkrEz0Qx0Tc1745921507.png\" width=\"234\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Colon and rectal pathology</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Distal <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> tumors, polyps, IBD</p>\n</td>\n</tr>\n</tbody>\n\n<p><strong>References:</strong></p>\n<ul><li>âł Barium swallow | Radiology Reference Article | Radiopaedia.org</li><li>âł Normal indentations on the esophagus in barium swallow</li><li>âł Definition of barium-meal photofluorography - NCI Dictionary of Cancer Terms</li><li>âł Barium Tests (Barium Meal, Swallow, Follow Through)</li><li>âł Double contrast barium enema technique | Radiology Reference Article</li><li>âł Grainger and Allisonâs Textbook of Diagnostic Radiology, 7th edition, Page 483</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The characteristic appearance of the esophagus on barium swallow, as shown in the image below, is seen in which of the following conditions?", "options": [{"label": "A", "text": "Diffuse oesophageal spasm", "correct": true}, {"label": "B", "text": "Esophageal carcinoma", "correct": false}, {"label": "C", "text": "Esophageal ulcer", "correct": false}, {"label": "D", "text": "Achalasia cardia", "correct": false}], "correct_answer": "A. Diffuse oesophageal spasm", "question_images": ["https://image.prepladder.com/content/WUGDk033LiLZx5wXE9h61745920997.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Barium Swallow Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diffuse <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> <span class=\"customMeta\" data-dictid=\"0338b655da16927771984b872baabb\">spasm</span> (DES)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corkscrew or <span class=\"customMeta\" data-dictid=\"b03d2e290016927771975cb2a45366\">rosary</span> <span class=\"customMeta\" data-dictid=\"b65b938dfa16927771826d42406534\">bead</span> esophagus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Uncoordinated contractions, chest pain, <span class=\"customMeta\" data-dictid=\"8502a8f15e16927771909160b28bf2\">intermittent</span> dysphagia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Esophageal carcinoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Irregular <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> defect, apple-core lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Progressive dysphagia, weight loss</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Esophageal ulcer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Niche or crater-like defect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Associated with <span class=\"customMeta\" data-dictid=\"def94cc96d16927771970d1a5cfb71\">reflux</span> or malignancy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Achalasia cardia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Birdâs <span class=\"customMeta\" data-dictid=\"273ed4fdf916927771827f19d7abc5\">beak</span> appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Failure of <span class=\"customMeta\" data-dictid=\"8a16e8c6941692777191cdd86f5bc5\">LES</span> relaxation, progressive dysphagia</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the most probable diagnosis for an elderly woman who is experiencing abdominal pain and swelling, considering her past medical history of scoliosis? Please refer to the provided X-ray image of the woman's upright abdomen for further information.", "options": [{"label": "A", "text": "Large bowel obstruction due to sigmoid volvulus", "correct": true}, {"label": "B", "text": "Large bowel obstruction due to faecolith", "correct": false}, {"label": "C", "text": "Cecal volvulus", "correct": false}, {"label": "D", "text": "Small bowel obstruction due to bowel perforation", "correct": false}], "correct_answer": "A. Large bowel obstruction due to sigmoid volvulus", "question_images": ["https://image.prepladder.com/notes/TTngqbnZWEKSDn4QKVyU1745389066.png"], "explanation_images": ["https://image.prepladder.com/notes/2t8SBw2jVxkgTGFThooy1745389216.png", "https://image.prepladder.com/notes/LxMkx7bR8DzFfu6MMONN1745389376.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:750px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sigmoid Volvulus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Caecal Volvulus</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sigmoid <span class=\"customMeta\" data-dictid=\"061f9a880e1692777202e47dbb3d3f\">volvulus</span> arises in the pelvis, specifically the left lower quadrant.</li>\n<li>It extends towards the right upper quadrant.</li>\n<li>It has an <strong>ahaustral </strong>appearance (lack of haustra).</li>\n<li>Causes <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> of the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> large bowel, leading to <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">dilation</span> of the ascending, transverse, and <span class=\"customMeta\" data-dictid=\"0cf8ac70611692777186b133d027f6\">descending</span> colon.</li>\n<li>A few gas-fluid levels may be seen.</li>\n<li><strong>Coffee-Bean Sign</strong>: The condition is characterized by a distended <span class=\"customMeta\" data-dictid=\"9008060dc21692777198e329f5be75\">sigmoid</span> loop with an inverted U shape, known as the coffee-bean sign (or <strong>kidney bean sign</strong>).</li>\n<li><strong>Whirlpool Sign</strong>: The whirl, or whirlpool sign is observed when the <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> rotates around its mesentery, resulting in whirls of the mesenteric vessels.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"49c306e91e1692777200be46fecf66\">torsion</span> is located in the <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> <span class=\"customMeta\" data-dictid=\"0fce15e71f1692777184feb9af5303\">colon</span> above the <span class=\"customMeta\" data-dictid=\"6f7908953b1692777189fa3a1a9655\">ileocecal</span> valve.</li>\n<li>Caecal <span class=\"customMeta\" data-dictid=\"061f9a880e1692777202e47dbb3d3f\">volvulus</span> arises in the right lower quadrant.</li>\n<li>It extends towards the <span class=\"customMeta\" data-dictid=\"b2332a96a2169277718756eb10e3e7\">epigastrium</span> or left upper quadrant.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"566fcef0991692777184068f36db82\">colonic</span> <strong>haustral </strong>pattern is maintained.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"0fce15e71f1692777184feb9af5303\">colon</span> is usually collapsed, and the small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> is distended.</li>\n<li>One gas-fluid level may be seen.</li>\n<li><strong>Definitive Sign</strong>: Upward <span class=\"customMeta\" data-dictid=\"5a50cd774d1692777186c56ec68eac\">displacement</span> of the <span class=\"customMeta\" data-dictid=\"b790a83bb41692777181cc3c0232af\">appendix</span> and <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> of the large <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> is a <span class=\"customMeta\" data-dictid=\"32b854324a1692777185c6c79fdc99\">definitive</span> sign of <span class=\"customMeta\" data-dictid=\"fca0acb15e169277718455018184a1\">cecal</span> volvulus.</li>\n<li>May show a U-shaped distended <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> segment and signs of ischemia, including <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">mural</span> thickening, <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> of the mesenteric fat, and <span class=\"customMeta\" data-dictid=\"8b4d9f2762169277719595156f1088\">pneumatosis</span> intestinalis.</li>\n<li><strong>Whirlpool Sign</strong>: A whirl sign may be apparent due to tight <span class=\"customMeta\" data-dictid=\"49c306e91e1692777200be46fecf66\">torsion</span> of the <span class=\"customMeta\" data-dictid=\"9f51fc9a741692777192ec164a061f\">mesentery</span> from a twist between the <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> and <span class=\"customMeta\" data-dictid=\"8833ce72c71692777187014d5585e7\">efferent</span> loops.</li>\n<li><strong>Coffee Bean Appearance</strong>: A \"coffee bean\" appearance may be seen in a loop of <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> colon.</li>\n<li><strong>Bird's <span class=\"customMeta\" data-dictid=\"273ed4fdf916927771827f19d7abc5\">Beak</span> Sign</strong>: Abrupt cut-off with âbird's beakâ tapering at the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"7e536c2543169277718488f0a5bb37\">cecum</span> is characteristic.</li>\n<li><strong>Central <span class=\"customMeta\" data-dictid=\"b790a83bb41692777181cc3c0232af\">appendix</span> sign</strong>: Abnormal <span class=\"customMeta\" data-dictid=\"b790a83bb41692777181cc3c0232af\">appendix</span> position near midline.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"sigmoid volvulus \" data-author=\"Mont4nha\" data-hash=\"11141\" data-license=\"CC0\" data-source=\"https://commons.wikimedia.org/wiki/File:Sigmoidvolvulus.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/2t8SBw2jVxkgTGFThooy1745389216.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"cacecal voluvulus\" data-author=\" Ian Bickle\" data-hash=\"11146\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/caecal-volvulus-6#image-10240993\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/LxMkx7bR8DzFfu6MMONN1745389376.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n</tbody>\n\n<p><strong>References:</strong></p>\n<ul><li>âł Sigmoid volvulus vs cecal volvulus | Radiology Reference Article | Radiopaedia.org</li><li>âł Sigmoid Volvulus Imaging</li><li>âł Cecal Volvulus Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with a history of dysphagia, which is more pronounced for liquids than solids. Which radiological sign is most likely to be seen?", "options": [{"label": "A", "text": "Rat-tail sign", "correct": true}, {"label": "B", "text": "Filling defect", "correct": false}, {"label": "C", "text": "Corkscrew esophagus", "correct": false}, {"label": "D", "text": "Apple-core lesion", "correct": false}], "correct_answer": "A. Rat-tail sign", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/R6MgHinwvVI8otCHzJqs1741088479.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Associated Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Appearance</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rat-tail sign</strong> (Correct Answer)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Achalasia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Smooth tapering of the <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">esophagus</span> at the LES</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Filling defect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Esophageal tumors, strictures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irregular <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> in the <span class=\"customMeta\" data-dictid=\"55052c0f0616927771829c99eec183\">barium</span> column</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Corkscrew esophagus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diffuse <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> <span class=\"customMeta\" data-dictid=\"0338b655da16927771984b872baabb\">spasm</span> (DES)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Multiple non-peristaltic contractions creating a \"corkscrew\" pattern</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Apple-core lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Esophageal or <span class=\"customMeta\" data-dictid=\"566fcef0991692777184068f36db82\">colonic</span> cancer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Constricted <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> with <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> edges, resembling an apple core</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 70-year-old patient presents with absolute constipation and abdominal distension. And the X-ray abdomen is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Caecal Volvulus", "correct": false}, {"label": "B", "text": "Sigmoid Volvulus", "correct": true}, {"label": "C", "text": "Intestinal Obstruction", "correct": false}, {"label": "D", "text": "Small Bowel Volvulus", "correct": false}], "correct_answer": "B. Sigmoid Volvulus", "question_images": ["https://image.prepladder.com/content/DSpTmQBW5S2JhnoneQBq1741057455.png"], "explanation_images": ["https://image.prepladder.com/content/OFB2juCfEkwFX2tZXqkq1741057520.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:573px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sigmoid Volvulus</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic constipation, long redundant <span class=\"customMeta\" data-dictid=\"9008060dc21692777198e329f5be75\">sigmoid</span> colon</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Coffee bean sign on X-ray, birdâs <span class=\"customMeta\" data-dictid=\"273ed4fdf916927771827f19d7abc5\">beak</span> sign on contrast enema</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abdominal distension, pain, absolute constipation, vomiting</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Endoscopic <span class=\"customMeta\" data-dictid=\"dfd87633931692777186f47063d1c2\">detorsion</span> (if no gangrene), surgery for <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> cases</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 6-week-old child is brought to the emergency department with recurrent projectile, non-bilious vomiting. Based on the radiograph provided, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Annular pancreas", "correct": false}, {"label": "B", "text": "Congenital Hypertrophic Pyloric Stenosis", "correct": true}, {"label": "C", "text": "Duodenal atresia", "correct": false}, {"label": "D", "text": "Meckelâs diverticulum", "correct": false}], "correct_answer": "B. Congenital Hypertrophic Pyloric Stenosis", "question_images": ["https://image.prepladder.com/content/xCv95fuJEO6r0S6bCEaX1724744632.png"], "explanation_images": ["https://image.prepladder.com/content/Na2uM1dqsyTv9Sn2ERli1724744764.png"], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\"&gt;Congenital&lt;/span&gt; Hypertrophic Pyloric S\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the condition depicted in the radiograph below.", "options": [{"label": "A", "text": "Pancreatic calcification", "correct": true}, {"label": "B", "text": "Mesenteric calcification", "correct": false}, {"label": "C", "text": "Horseshoe kidney", "correct": false}, {"label": "D", "text": "Jejunal fecolith", "correct": false}], "correct_answer": "A. Pancreatic calcification", "question_images": ["https://image.prepladder.com/content/KbJtOiADxXdDCJNhbYVo1724751554.png"], "explanation_images": [], "explanation": "<p>Correct Option A - P\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What investigation is being performed in the image below?", "options": [{"label": "A", "text": "Fluoroscopy", "correct": false}, {"label": "B", "text": "Barium swallow", "correct": true}, {"label": "C", "text": "X-ray for alkali ingestion", "correct": false}, {"label": "D", "text": "X-ray for acid ingestion", "correct": false}], "correct_answer": "B. Barium swallow", "question_images": ["https://image.prepladder.com/content/wn5pjYf7G7fETPRSCd551724752809.png"], "explanation_images": ["https://image.prepladder.com/content/ya2XSFgtrujoFi6dokqH1724849352.png"], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"55052c0f0616927771829c99eec183\"&gt;Barium&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify pancreas, liver, and spleen?", "options": [{"label": "A", "text": "A-liver, B-pancreas, C-spleen", "correct": true}, {"label": "B", "text": "A-Kidney, B-liver, C-pancreas", "correct": false}, {"label": "C", "text": "A-pancreas, B-liver, C-spleen", "correct": false}, {"label": "D", "text": "A-spleen, B-kidney, C-liver", "correct": false}], "correct_answer": "A. A-liver, B-pancreas, C-spleen", "question_images": ["https://image.prepladder.com/notes/5QwvRttqwbm0xttADPF91747657032.png"], "explanation_images": ["https://image.prepladder.com/notes/w1iYH0yNlJXq91bGQEE01747657124.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male presented with severe abdominal pain following alcohol intake. Make a diagnosis based on the given X-ray.", "options": [{"label": "A", "text": "Pneumoperitoneum", "correct": true}, {"label": "B", "text": "SBO", "correct": false}, {"label": "C", "text": "Esophageal perforation", "correct": false}, {"label": "D", "text": "Pneumomediastinum", "correct": false}], "correct_answer": "A. Pneumoperitoneum", "question_images": ["https://image.prepladder.com/content/j5UmsEOq2w5lxOHl6hg81747225272.png"], "explanation_images": ["https://image.prepladder.com/content/nOeMrJ28jkucgh0pjqMa1747381153.png", "https://image.prepladder.com/content/H9yNcNip3v6yM5Vf8JfQ1747381159.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the condition in the image shown below:", "options": [{"label": "A", "text": "Duodenal atresia", "correct": false}, {"label": "B", "text": "Jejunal atresia", "correct": true}, {"label": "C", "text": "Small bowel obstruction", "correct": false}, {"label": "D", "text": "Ileal atresia", "correct": false}], "correct_answer": "B. Jejunal atresia", "question_images": ["https://image.prepladder.com/content/NPiuHH0haa6bihHCsL1L1747225483.png"], "explanation_images": ["https://image.prepladder.com/content/rxq6Yv8QKndSVjCmzGBK1747381260.png", "https://image.prepladder.com/content/XIETIJvzHgW0vb4Vep4C1747381270.png", "https://image.prepladder.com/content/wOIYgOp8XktF0NrP6jVz1747381279.png", "https://image.prepladder.com/content/OMn53n8oN2KImRaButeT1747381288.png", "https://image.prepladder.com/content/IXidx7BCRkEtOm7Wl0HM1747381296.png", "https://image.prepladder.com/content/2caYWt4nfWr3neM4zXmF1747381321.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:728px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Radiological Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Explanation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Normal Abdomen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Single bubble in the stomach</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A single air bubble seen in the left upper <span class=\"customMeta\" data-dictid=\"3a757d7c1216927771968223be411d\">quadrant</span> corresponds to the <span class=\"customMeta\" data-dictid=\"67492c42be16927772039f6e37110e\">fundus</span> of the stomach. A large single bubble is seen in cases of pyloric atresia, GOO.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jeremy Jones\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/normal-abdominal-x-ray-1\" data-tags=\"\" height=\"485\" src=\"https://image.prepladder.com/content/rxq6Yv8QKndSVjCmzGBK1747381260.png\" width=\"359\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pyloric <span class=\"customMeta\" data-dictid=\"5c10d19e4416927771829871a1737f\">Atresia</span> (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>\"Single bubble\" sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A single distended stomach with no air in the small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> or beyond, caused by <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> at the pylorus.</p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Samir,\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:GOO_AXR.jpg\" data-tags=\"\" height=\"452\" src=\"https://image.prepladder.com/content/XIETIJvzHgW0vb4Vep4C1747381270.png\" width=\"360\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Duodenal <span class=\"customMeta\" data-dictid=\"5c10d19e4416927771829871a1737f\">Atresia</span> </strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>\"Double bubble\" sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Distended stomach and <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> duodenum; no <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> gas due to <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> at the duodenum.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Pediatric Radiology Olgahospital Klinikum Stuttgart\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:DuodAtres.png\" data-tags=\"\" height=\"485\" src=\"https://image.prepladder.com/content/wOIYgOp8XktF0NrP6jVz1747381279.png\" width=\"386\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Jejunal Atresia</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>\"Triple bubble\" sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Three distended loops of <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> (stomach, duodenum, <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> jejunum) with no <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> gas.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Hisham Alwakkaa\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/jejunal-atresia-2#image-33384261\" data-tags=\"\" height=\"649\" src=\"https://image.prepladder.com/content/OMn53n8oN2KImRaButeT1747381288.png\" width=\"388\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ileal Atresia</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Multiple air-fluid levels</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dilated small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> loops with air-fluid levels and no gas in the large intestine, more <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> than jejunal atresia.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jones J, Campos A, Yap J, et al\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/ileal-atresia\" data-tags=\"\" height=\"529\" src=\"https://image.prepladder.com/content/IXidx7BCRkEtOm7Wl0HM1747381296.png\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A newborn presents with bilious vomiting. Which sign is depicted in the following radiograph?", "options": [{"label": "A", "text": "Double bubble sign", "correct": true}, {"label": "B", "text": "Air crescent sign", "correct": false}, {"label": "C", "text": "Cupola sign", "correct": false}, {"label": "D", "text": "Triple bubble sign:", "correct": false}], "correct_answer": "A. Double bubble sign", "question_images": ["https://image.prepladder.com/content/1d9iMreTaf0TOVi4XoqK1695741126.png"], "explanation_images": [], "explanation": "<p>Correct option A - Double bubble sig\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td><strong>Radiological sign</strong></td>\n<td><strong>Seen in</strong></td>\n</tr>\n<tr>\n<td>Double bubble sign</td>\n<td>Duodenal atresia</td>\n</tr>\n<tr>\n<td>Air <span class=\"customMeta\" data-dictid=\"0539eefe3f169277718547881d187d\">crescent</span> sign</td>\n<td>Invasive <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> aspergillosis</td>\n</tr>\n<tr>\n<td>Cupola sign</td>\n<td>Pneumoperitoneum</td>\n</tr>\n<tr>\n<td>Triple bubble sign</td>\n<td>Jejunal atresia</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please identify the section of the intestine shown in the barium study provided.", "options": [{"label": "A", "text": "Ileum", "correct": false}, {"label": "B", "text": "Transverse colon", "correct": false}, {"label": "C", "text": "Jejunum", "correct": true}, {"label": "D", "text": "Splenic flexure", "correct": false}], "correct_answer": "C. Jejunum", "question_images": ["https://image.prepladder.com/notes/hdM8MWsBfgLDdwneq8g71747383845.png"], "explanation_images": ["https://image.prepladder.com/content/I7GDDD6b140DzBlaqjfZ1746437254.png", "https://image.prepladder.com/content/xfVqu0mmhFd4Njva7Z5p1746437254.png", "https://image.prepladder.com/content/RzKcKLpkuRPtTlqMRVZo1746437254.png", "https://image.prepladder.com/content/G9oXlSpWU1TcuZi6rM2W1746437254.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:727px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Radiological Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Explanation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Normal Abdomen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Single bubble in the stomach</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A single air bubble seen in the left upper <span class=\"customMeta\" data-dictid=\"3a757d7c1216927771968223be411d\">quadrant</span> corresponds to the <span class=\"customMeta\" data-dictid=\"67492c42be16927772039f6e37110e\">fundus</span> of the stomach. A large single bubble is seen in cases of pyloric atresia, GOO.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jeremy Jones\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/normal-abdominal-x-ray-1\" data-tags=\"\" height=\"228\" src=\"https://image.prepladder.com/content/I7GDDD6b140DzBlaqjfZ1746437254.png\" width=\"169\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pyloric Atresia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>\"Single bubble\" sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A single distended stomach with no air in the small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> or beyond, caused by <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> at the pylorus.</p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Samir,\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:GOO_AXR.jpg\" data-tags=\"\" height=\"295\" src=\"https://image.prepladder.com/content/xfVqu0mmhFd4Njva7Z5p1746437254.png\" width=\"235\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Duodenal <span class=\"customMeta\" data-dictid=\"5c10d19e4416927771829871a1737f\">Atresia</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>\"Double bubble\" sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Distended stomach and <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> duodenum; no <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> gas due to <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> at the duodenum.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Pediatric Radiology Olgahospital Klinikum Stuttgart\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:DuodAtres.png\" data-tags=\"\" height=\"328\" src=\"https://image.prepladder.com/content/RzKcKLpkuRPtTlqMRVZo1746437254.png\" width=\"261\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Jejunal Atresia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>\"Triple bubble\" sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Three distended loops of <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> (stomach, duodenum, <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> jejunum) with no <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> gas.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Hisham Alwakkaa\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/jejunal-atresia-2#image-33384261\" data-tags=\"\" height=\"443\" src=\"https://image.prepladder.com/content/G9oXlSpWU1TcuZi6rM2W1746437254.png\" width=\"265\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ileal Atresia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Multiple air-fluid levels</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dilated small <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> loops with air-fluid levels and no gas in the large intestine, more <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> than jejunal atresia.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old female patient presents to the emergency department with chills and rigors. She has acute pain in the right flank region. The imaging is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Cholecystitis", "correct": false}, {"label": "B", "text": "Emphysematous pyelonephritis", "correct": true}, {"label": "C", "text": "Small bowel obstruction", "correct": false}, {"label": "D", "text": "Volvulus", "correct": false}], "correct_answer": "B. Emphysematous pyelonephritis", "question_images": ["https://image.prepladder.com/notes/t8014f4HddjraWWP9tWe1747383985.png"], "explanation_images": ["https://image.prepladder.com/content/yccrUiBSAXey4nHOjhtt1746437621.png", "https://image.prepladder.com/content/n2aU1nAfSNGCSVBWUkeE1746437621.png", "https://image.prepladder.com/content/3UBNAmKDHfWoW3AOBnTa1746437621.png", "https://image.prepladder.com/content/sixQhNzh0gATlSEezrYg1746437664.png", "https://image.prepladder.com/content/TOVSApeKPSnUNaFWV92f1746437680.png", "https://image.prepladder.com/content/3Ev1ZRkzoYbYmyBkf77e1746437684.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:700px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<h4><strong>Acute <span class=\"customMeta\" data-dictid=\"7d244db63c1692777196490682ecc8\">Pyelonephritis</span> </strong></h4>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<h4><strong>Xanthogranulomatous Pyelonephritis</strong></h4>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<h4><strong>Emphysematous Pyelonephritis</strong></h4>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ultrasound (USG):</strong> This may show <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> enlargement, <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> echogenicity, and dilated collecting systems.</p>\n<p> </p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Kao, Jeff &amp; Wu, Ching-Jiunn.\" data-hash=\"\" data-license=\"CC BY-NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/Diffuse-acute-pyelonephritis-in-a-31-year-old-woman-A-Longitudinal-ultrasound-of-the_fig1_244858312\" data-tags=\"\" height=\"202\" src=\"https://image.prepladder.com/content/yccrUiBSAXey4nHOjhtt1746437621.png\" width=\"219\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align: center;\"> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ultrasound (USG):</strong> Shows an enlarged <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> with <strong>echogenic staghorn <span class=\"customMeta\" data-dictid=\"eae898f16d1692777183cc3469a664\">calculi</span> and <span class=\"customMeta\" data-dictid=\"5543384a9b169277718985e08cf7f8\">hypoechoic</span> masses</strong> replacing <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> parenchyma.</p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Ciccarese, Federica &amp; Brandi, Nicolò &amp; Corcioni, Beniamino &amp; Golfieri, Rita &amp; Gaudiano, Caterina.\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Radiographic-and-ultrasonographic-US-appearance-of-xanthogranulomatous-Pyelonephritis_fig1_347212248\" data-tags=\"\" height=\"184\" src=\"https://image.prepladder.com/content/n2aU1nAfSNGCSVBWUkeE1746437621.png\" width=\"219\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align: center;\"> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Plain <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">Abdominal</span> X-ray:</strong> Detects gas in the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> region in about 70% of cases.</p>\n<p> </p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Montelongo-RodrĂguez, Fred &amp; Robles-Torres, JosĂŠ &amp; GarcĂa-Saucedo, JesĂşs &amp; RuĂz-Galindo, EfraĂn &amp; Pacheco-Molina, Carlos &amp; GĂłmez-Guerra, Lauro.\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Abdominal-x-ray-shows-gas-distributed-in-the-topography-of-the-right-kidney-arrows_fig1_354626047\" data-tags=\"\" height=\"239\" src=\"https://image.prepladder.com/content/3UBNAmKDHfWoW3AOBnTa1746437621.png\" width=\"219\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<p style=\"text-align: center;\"> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Contrast-enhanced CT:</strong> Most sensitive, showing wedge-shaped <span class=\"customMeta\" data-dictid=\"11309a56bc1692777189e89a8d3041\">hypodense</span> areas, <span class=\"customMeta\" data-dictid=\"83b138c27e16927771993110e65f52\">striated</span> nephrograms, and <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> wall thickening.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Irfan Moinuddin, Erika Bracamonte, Bijin Thajudeen, Amy Sussman, Machaiah Madhrira, James Costello\" data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1155/2015/250530\" data-tags=\"\" height=\"192\" src=\"https://image.prepladder.com/content/sixQhNzh0gATlSEezrYg1746437664.png\" width=\"342\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>CT Scan</strong> reveals a non-functioning kidney, <strong>staghorn calculus, expanded calyces, and <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> changes</strong>. A characteristic bear <span class=\"customMeta\" data-dictid=\"27e3bff9a21692777194ab2ee09585\">paw</span> sign is noted.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Xu, Zhunan &amp; Cai, Tong &amp; Zhang, Xuebao &amp; Wu, Jitao &amp; Liu, Chu. \" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Bear-paw-sign-multiple-rounded-low-density-areas-with-enhancing-rings-arranged-in-a_fig1_355754695\" data-tags=\"\" height=\"342\" src=\"https://image.prepladder.com/content/TOVSApeKPSnUNaFWV92f1746437680.png\" width=\"342\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align: center;\"> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>CT:</strong> Gold standard, reveals gas within the kidney, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> enlargement, <span class=\"customMeta\" data-dictid=\"419338f1b71692777195411fd0bfcd\">perinephric</span> stranding and abscesses. Helps classify into Type 1 (gas without fluid) or Type 2 (gas with fluid).</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Dutta, Deep &amp; Ks, Shivaprasad &amp; Kumar, Manoj &amp; Biswas, Dibakar &amp; Ghosh, Sujoy &amp; Mukhopadhyay, Pradip &amp; MUKHOPADHYAY, SATINATH &amp; Chowdhury, Subhankar.\" data-hash=\"\" data-license=\"CC BY-NC SA 3.0\" data-source=\"https://www.researchgate.net/figure/CT-abdomen-showing-enlargement-distortion-of-architecture-and-loss-of-corticomedullary_fig2_258704358\" data-tags=\"\" height=\"354\" src=\"https://image.prepladder.com/content/3Ev1ZRkzoYbYmyBkf77e1746437684.png\" width=\"342\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align: center;\"> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Acute infection of the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> involving the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> and collecting system is usually caused by <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> bacteria.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>It is a chronic <span class=\"customMeta\" data-dictid=\"9e1f97f6ad169277718805c2dd35c1\">granulomatous</span> response to <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> infection - that leads to the destruction of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> and its replacement by lipid-laden foamy macrophages.</li>\n<li>Destruction spreads from the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> pelvisâmedullaâ cortex.</li>\n<li>Usually, staghorn <span class=\"customMeta\" data-dictid=\"7c0090409b16927771839521583331\">calculus</span> is present in the pelvis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Severe <span class=\"customMeta\" data-dictid=\"f826a1a46e1692777193319fa1e5ed\">necrotizing</span> infection with gas accumulation in and around the kidney, primarily in <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> patients.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following: 1. Football sign a. Hypertrophic pyloric stenosis 2. String sign b. Achalasia cardia 3. Rat tail sign c. Ileocecal TB 4. Inverted umbrella sign d. Pneumoperitoneum", "options": [{"label": "A", "text": "1-b, 2-d, 3-a, 4-c", "correct": false}, {"label": "B", "text": "1-c, 2-a, 3-b, 4-d", "correct": false}, {"label": "C", "text": "1-d, 2-b, 3-a, 4-c", "correct": false}, {"label": "D", "text": "1-d, 2-a, 3-b, 4-c", "correct": true}], "correct_answer": "D. 1-d, 2-a, 3-b, 4-c", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/06VizOCtEuuDEoy3QLrq1745389855.png", "https://image.prepladder.com/notes/IhdSxI6Fjnjq5QmTC1381745389962.png", "https://image.prepladder.com/notes/x7pSYm3wdiFr8wPu3vdk1745390011.png", "https://image.prepladder.com/notes/cqpT4JqTzhqVGXpmxWmJ1745390082.png"], "explanation": "\n<p><strong>References:</strong></p>\n<ul><li>âł Nelson Textbook of Pediatrics, 21st edition, Page 1947</li><li>âł Grainger and Allisonâs Textbook of Diagnostic Radiology, 7th edition, Page 463-465</li><li>âł Achalasia | Radiology Reference Article | Radiopaedia.org</li><li>âł David Sutton Textbook of Radiology and Imaging, Volume 1, 8th edition, Page 2254-</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following images accurately represents the medical condition described in the given scenario?", "options": [{"label": "A", "text": "Diaphragmatic hernia", "correct": true}, {"label": "B", "text": "Intestinal obstruction", "correct": false}, {"label": "C", "text": "Pleural effusion", "correct": false}, {"label": "D", "text": "Pneumonia", "correct": false}], "correct_answer": "A. Diaphragmatic hernia", "question_images": ["https://image.prepladder.com/content/wC8trEMv6YKAqbKHyciZ1697526425.png"], "explanation_images": [], "explanation": "<p>Correct Option A: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following could be the cause of the presence of free air under the diaphragm except?", "options": [{"label": "A", "text": "Duodenal ulcer perforation", "correct": false}, {"label": "B", "text": "Post laparoscopy", "correct": false}, {"label": "C", "text": "Chilaiditi syndrome", "correct": false}, {"label": "D", "text": "Acute intestinal obstruction", "correct": true}], "correct_answer": "D. Acute intestinal obstruction", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/wTzNF6vRo4x7f0bhxO4W1697542967.png", "https://image.prepladder.com/content/TOw0F3KSqoZzp4x8L6RL1697542943.png", "https://image.prepladder.com/content/2ugE20hEfEqaMwPRTRyW1697542909.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which of the following medical conditions can the X-ray finding be observed?", "options": [{"label": "A", "text": "Esophageal atresia", "correct": false}, {"label": "B", "text": "Esophageal stenosis", "correct": false}, {"label": "C", "text": "Reflux esophagitis", "correct": true}, {"label": "D", "text": "Barrettâs esophagus", "correct": false}], "correct_answer": "C. Reflux esophagitis", "question_images": ["https://image.prepladder.com/content/F2Dj9eejk0QHsILkEHmB1691455377.png"], "explanation_images": ["https://image.prepladder.com/content/HTscuoR6ZQw6uxKBtW3I1691455396.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the sign?", "options": [{"label": "A", "text": "Claw sign", "correct": false}, {"label": "B", "text": "Target sign", "correct": true}, {"label": "C", "text": "Coffee bean sign", "correct": false}, {"label": "D", "text": "Lead pipe sign", "correct": false}], "correct_answer": "B. Target sign", "question_images": ["https://image.prepladder.com/content/HePk6xOgM9zC7O43Q4Pq1698755076.png"], "explanation_images": ["https://image.prepladder.com/content/W2VDOgDkfTd55etKd31O1698755143.png", "https://image.prepladder.com/content/HKWEahgNcPwOYNVVp4ur1698755218.png", "https://image.prepladder.com/content/zrsquAkvZRAKoMvFnrKz1698755258.png", "https://image.prepladder.com/content/W14MYZ1oD5OvrwQiZLCy1698755368.png"], "explanation": "<p>Correct Option B: \n<table>\n<tbody>\n<tr>\n<td><strong>Definition</strong></td>\n<td>Intussusception is a medical condition in which one portion of the <span class=\"customMeta\" data-dictid=\"7840cca3ed16927771901d2f6cb32b\">intestine</span> (typically the small intestine) invaginates or telescopes into another segment of the intestine. This can lead to <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> obstruction, <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> blood flow, and potential tissue damage. It is most common in infants and young children.</td>\n</tr>\n<tr>\n<td><strong>Prevalence</strong></td>\n<td>Intussusception is relatively common in children, with a peak <span class=\"customMeta\" data-dictid=\"17cd3771bb1692777190950c142dbe\">incidence</span> between 3 months and 6 years of age. It is rare in adults but can occur.</td>\n</tr>\n<tr>\n<td><strong>Causes</strong></td>\n<td>The exact cause is often unknown, but it may be <span class=\"customMeta\" data-dictid=\"3978e9614f1692777200abbe4cfa34\">triggered</span> by infections, changes in <span class=\"customMeta\" data-dictid=\"4fb6bd90f016927771918d4a2993ed\">lymphatic</span> tissue in the intestine, or sometimes a structural lead point such as a <span class=\"customMeta\" data-dictid=\"b5c135c2311692777196832953e406\">polyp</span> or tumor.</td>\n</tr>\n<tr>\n<td><strong>Symptoms</strong></td>\n<td>- <strong>Children:</strong> Sudden, severe <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, drawing knees to the chest, vomiting, and \"currant jelly\" <span class=\"customMeta\" data-dictid=\"44335bb8bf1692777199a956cb31bf\">stool</span> (blood and <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> in the stool). - <strong>Adults:</strong> <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">Abdominal</span> pain, nausea, and vomiting.</td>\n</tr>\n<tr>\n<td><strong>Diagnosis</strong></td>\n<td>- Clinical evaluation based on symptoms and physical examination.- <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> studies, such as <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> or <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> X-rays, can confirm the diagnosis by showing the classic \"target sign.\"</td>\n</tr>\n<tr>\n<td><strong>Treatment</strong></td>\n<td>- <strong>Enema (Air or Barium):</strong> Often the first-line treatment. It can both diagnose and treat <span class=\"customMeta\" data-dictid=\"ecba80da7b1692777190a1ae56e0a7\">intussusception</span> by pushing the telescoped segment back into its normal position.- <strong>Surgery:</strong> If <span class=\"customMeta\" data-dictid=\"981cb55fe1169277718759ac720c5d\">enema</span> is unsuccessful or if complications like <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> <span class=\"customMeta\" data-dictid=\"23b5d65f051692777195987380382d\">perforation</span> occur, surgery may be necessary to correct the problem.</td>\n</tr>\n<tr>\n<td><strong>Prognosis</strong></td>\n<td>The <span class=\"customMeta\" data-dictid=\"e580b4033e169277719609af594c16\">prognosis</span> is generally good, especially when diagnosed and treated promptly. Delayed diagnosis or treatment can lead to complications, such as <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> or perforation.</td>\n</tr>\n<tr>\n<td><strong>Complications</strong></td>\n<td>- <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">Bowel</span> perforation- Infection in the <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> cavity- Peritonitis- <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">Scar</span> tissue (adhesions) after surgery</td>\n</tr>\n<tr>\n<td><strong>Key Points</strong></td>\n<td>- <span class=\"customMeta\" data-dictid=\"ecba80da7b1692777190a1ae56e0a7\">Intussusception</span> is a common cause of <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> in children.- Diagnosis is typically based on clinical symptoms and <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> studies.- Early treatment is important to prevent complications.- In adults, <span class=\"customMeta\" data-dictid=\"ecba80da7b1692777190a1ae56e0a7\">intussusception</span> is often associated with a <span class=\"customMeta\" data-dictid=\"c0c247b89916927771948bc5e6d39c\">pathological</span> lead point and may require <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> intervention.</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Investigation of choice for GERD:", "options": [{"label": "A", "text": "USG", "correct": false}, {"label": "B", "text": "HIDA", "correct": false}, {"label": "C", "text": "Manometry", "correct": false}, {"label": "D", "text": "24 hour pH monitoring", "correct": true}], "correct_answer": "D. 24 hour pH monitoring", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40 yr old man comes with a history of retrosternal chest pain and dysphagia, Barium meal was done given below. What is the classical pattern of dysphagia found in this condition?", "options": [{"label": "A", "text": "More for liquids &amp;gt;&amp;gt; solids", "correct": true}, {"label": "B", "text": "Progressive Dysphagia for liquids = solids", "correct": false}, {"label": "C", "text": "Progressive dysphagia more for solids &amp;gt;&amp;gt; liquids", "correct": false}, {"label": "D", "text": "Intermittent dysphagia for solids = liquids", "correct": false}], "correct_answer": "A. More for liquids &gt;&gt; solids", "question_images": ["https://image.prepladder.com/content/gyf55uGT1rYtlwkBdJFa1691480387.png"], "explanation_images": [], "explanation": "<p>Correct Option A\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Radiological Findings</strong></p>\n</td>\n<td>\n<p><strong>ACHLASIA CARDIA</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Esophageal Dilatation</p>\n</td>\n<td>\n<p>Enlarged <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">esophagus</span> due to functional <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> at the lower <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> (LES)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Bird's <span class=\"customMeta\" data-dictid=\"273ed4fdf916927771827f19d7abc5\">Beak</span> Appearance</p>\n</td>\n<td>\n<p>Distal smooth, short segment tapering resembling a bird's beak, seen on <span class=\"customMeta\" data-dictid=\"55052c0f0616927771829c99eec183\">barium</span> swallow study</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Lack of Peristalsis</p>\n</td>\n<td>\n<p>Absence of normal peristaltic contractions in the <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> body</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Residual Contrast Material</p>\n</td>\n<td>\n<p>Incomplete <span class=\"customMeta\" data-dictid=\"397f16a7a71692777187ffffefa7e6\">emptying</span> of contrast material from the <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">esophagus</span> into the stomach</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pseudo-Diverticula Formation</p>\n</td>\n<td>\n<p>Outpouchings or <span class=\"customMeta\" data-dictid=\"c9f59a135316927771862d79e1f59b\">diverticula</span> may <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> in the dilated esophagus</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Narrowing of LES</p>\n</td>\n<td>\n<p>Narrowing or <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> opening of the lower <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> sphincter</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Rhythmic Contractions</p>\n</td>\n<td>\n<p>Simultaneous, rhythmic contractions of the <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> body, resulting in a \"corkscrew\" appearance</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What would be your subsequent step when encountering a child who has a documented case of ingesting a button battery?", "options": [{"label": "A", "text": "Give oral fluids", "correct": false}, {"label": "B", "text": "Remove endoscopically", "correct": true}, {"label": "C", "text": "Reassure and check whether passed in stools", "correct": false}, {"label": "D", "text": "Induce vomiting", "correct": false}], "correct_answer": "B. Remove endoscopically", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 44 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 40 y/o male presents with a history of urinary incontinence and recurrent urinary tract infections. Imaging reveals a bladder with a thickened, trabeculated wall and an elongated shape, resembling a cone. Which of the following bladder appearances is most likely to be seen in this patient?", "options": [{"label": "A", "text": "Christmas tree bladder", "correct": true}, {"label": "B", "text": "Keyhole appearance", "correct": false}, {"label": "C", "text": "Fetal skull calcification", "correct": false}, {"label": "D", "text": "Teardrop bladder", "correct": false}], "correct_answer": "A. Christmas tree bladder", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/5UxbjZKfloS8JtGyjpSt1744026592.png", "https://image.prepladder.com/notes/kuCR1GwFHAzYfHdUdEX71744026609.png", "https://image.prepladder.com/notes/8z6G2L9Klcz8UdU8NmVa1744026639.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Bladder Appearances in Radiology</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Christmas Tree bladder</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Teardrop bladder</strong></p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>⢠Also known as the fir-tree bladder, it is typically seen in the <span class=\"customMeta\" data-dictid=\"fec88fc386169277719326fdef547f\">neurogenic</span> <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> due to detrusor-sphincter dyssynergia.</p>\n<p>⢠The <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> appears elongated and trabeculated, resembling a pine <span class=\"customMeta\" data-dictid=\"1c42c9fe83169277718486ee5a82e9\">cone</span> or Christmas tree.</p>\n<p>⢠Often associated with suprasacral lesions or epiconal lesions (above or around S2-S4). </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"X-ray Fluoroscopy showing Christmas tree appearance\" data-author=\"Mohammad Taghi Niknejad\" data-hash=\"7915\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/christmas-tree-appearance-neurogenic-bladder#image-5368766\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/5UxbjZKfloS8JtGyjpSt1744026592.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Refers to a pear-shaped <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> caused by external compression. </p>\n<p>⢠It can result from <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> hematoma, <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> lipomatosis, or <span class=\"customMeta\" data-dictid=\"7a1ae24f701692777187a7f60bbd9f\">excess</span> <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> fat.</p>\n<p>⢠The <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> may appear inverted or upright, depending on the source of compression.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"X-ray Fluoroscopy showing Pear shaped bladder\" data-author=\"Ian Bickle\" data-hash=\"7916\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/pear-shaped-bladder-1#image-2749401\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/kuCR1GwFHAzYfHdUdEX71744026609.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Fetal Skull Calcification</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Keyhole Appearance</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>⢠Occurs in advanced schistosomiasis.</p>\n<p>⢠The <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> wall calcifies in a ringlike pattern, resembling a <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> skull on radiologic images.</p>\n<p>⢠Common in cases of <span class=\"customMeta\" data-dictid=\"2942e9d19616927772014161ee8f70\">urogenital</span> schistosomiasis, often with <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> of the ureters as well.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT showing Urinary &lt;span class=\" custommeta\"=\"\" data-dictid=\"e6cfda323816927771839cc83e376d\"/>bladder wall calcification.\" data-author=\"Ito, Katsuhiro &amp; Takahashi, Toshifumi &amp; Kanno, Toru &amp; Okada, Takashi &amp; Higashi, Yoshihito &amp; Yamada, Hitoshi. \" data-hash=\"7917\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Coronal-and-axial-CT-images-of-bladder-a-b-and-kidney-c-d-A-thin-layer-of_fig2_340733352\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/nJJr46SMdfpp0CHLk39V1744026625.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Seen in patients with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> urethral valves.</p>\n<p>⢠It is the <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">dilation</span> of the <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> <span class=\"customMeta\" data-dictid=\"a594ff734f16927772016f656d39eb\">urethra</span> and the presence of a distended, thick-walled bladder. </p>\n<p>⢠The <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> appearance resembles a keyhole.</p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Ultrasound showing keyhole sign-Teardrop bladder\" data-author=\"Schierbaum, Luca &amp; Schneider, Sophia &amp; Herms, Stefan &amp; Sivalingam, Sugirthan &amp; Fabian, Julia &amp; Reutter, Heiko &amp; Weber, Stefanie &amp; Merz, Waltraut &amp; Tkaczyk, Marcin &amp; Miklaszewska, Monika &amp; Sikora, Przemyslaw &amp; Szmigielska, Agnieszka &amp; Krzemien, Grazyna &amp; Zachwieja, Katarzyna &amp; SzczepaĹska, Maria &amp; Taranta-Janusz, Katarzyna &amp; Kroll, PaweĹ &amp; Polok, Marcin &amp; Zaniew, Marcin &amp; Hilger, Alina. \" data-hash=\"7918\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/The-phenotype-of-LUTO-a-b-Prenatal-fetal-ultrasound-with-typical-keyhole-sign-of-the_fig1_354728239\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/8z6G2L9Klcz8UdU8NmVa1744026639.png\">\n<figcaption>{{caption_text}}</figcaption>\n</img></figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mBuZy2f0EpcsPnjFUNTe1748783443.mp3", "video": ""}, {"text": "A 55 y/o woman undergoing routine health screening is found to have an incidental adrenal mass on ultrasound. The lesion is smooth, round, hypoechoic, and measures 2.5 cm with low vascularity. A non-contrast CT scan shows a density of 8 HU. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pheochromocytoma", "correct": false}, {"label": "B", "text": "Adrenal calcification", "correct": false}, {"label": "C", "text": "Adrenal adenoma", "correct": true}, {"label": "D", "text": "Metastasis", "correct": false}], "correct_answer": "C. Adrenal adenoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/0JFeecOfaq8LoqDjvRry1744033454.png", "https://image.prepladder.com/notes/gXO1BLNXQHKfEjuk2x8W1744033468.png", "https://image.prepladder.com/notes/EADzW1Xa3kGK2da1LM8t1744033491.png", "https://image.prepladder.com/notes/Y9hrRnHGCE8SFTFmEpgp1744033506.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Adrenal Adenoma</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Pheochromocytoma</strong></p>\n<p><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Adrenal Calcification</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>Common <span class=\"customMeta\" data-dictid=\"1bbae82f1f16927771824f797639fa\">benign</span> tumour, often hormonally inactive and less than 3 cm.</p>\n<p> </p>\n<p><strong>Ultrasound</strong>: <strong>Smooth, round, hypoechoic, and low vascularity.</strong></p>\n<p><strong>CT</strong>: </p>\n<p><strong>⢠Non-contrast shows a low density (&lt;10 HU) if lipid-rich, and 10â30 HU if lipid-poor.</strong></p>\n<p>⢠Rapid <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> with &gt;60% <span class=\"customMeta\" data-dictid=\"67d67b341916927772029cd0d951df\">washout</span> on contrast-enhanced CT.</p>\n<p><strong>MRI</strong>: Signal drop on T1 out-of-phase <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> due to <span class=\"customMeta\" data-dictid=\"e572b487a11692777190b9f3b05fd3\">intralesional</span> lipid.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Rare <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">adrenal</span> <span class=\"customMeta\" data-dictid=\"53abb386551692777192c4d1f1f5ed\">medulla</span> tumour that secretes catecholamines.</p>\n<p> </p>\n<p><strong>CT</strong>: Heterogeneous and strongly enhancing.</p>\n<p><strong>MRI</strong>:</p>\n<p>⢠T2 is <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> with a \"light bulb\" appearance.</p>\n<p>⢠No signal loss on out-of-phase imaging.</p>\n<p>⢠Fluidâfluid levels may indicate haemorrhage.</p>\n<p><strong>MIBG</strong>: Localizes tumour via increased <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">adrenal</span> uptake.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>May result from old haemorrhage, infection, or various diseases (e.g., tuberculosis, neuroblastoma).</p>\n<p> </p>\n<p><strong>Plain X-ray</strong>: Calcifications may be diffuse, stippled, or arc-like depending on the cause.</p>\n<p> </p>\n<p><strong>CT</strong>:</p>\n<p>⢠Early tuberculosis: Enlarged <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">adrenal</span> with <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> enhancement.</p>\n<p>⢠Advanced tuberculosis: Atrophic adrenals with scattered calcifications.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Adrenal CT scan of patient show left adrenal adenoma\" data-author=\"Layden, Brian &amp; Hahr, Allison &amp; Elaraj, Dina.\" data-hash=\"7957\" data-license=\"CC BY 2.0\" data-source=\"https://www.researchgate.net/figure/Adrenal-CT-scan-of-patient-show-left-adrenal-adenoma-see-arrow_fig1_232740601\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/0JFeecOfaq8LoqDjvRry1744033454.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"MRI - T2 hyperintense âLight bulbâ sign\" data-author=\"Essam G Ghonaim\" data-hash=\"7958\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/adrenal-pheochromocytoma#image-11864619\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/gXO1BLNXQHKfEjuk2x8W1744033468.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"MIBG scan showing increased radiotracer uptake on the left adrenal gland\" data-author=\"Roberto Schubert\" data-hash=\"7959\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/pheochromocytoma-6#image-1586305\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/EADzW1Xa3kGK2da1LM8t1744033491.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"X-ray showing bilateral adrenal calcification\" data-author=\"Vikas Shah\" data-hash=\"7960\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/calcified-adrenal-glands-and-spigelian-hernia#image-26774304\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/Y9hrRnHGCE8SFTFmEpgp1744033506.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tBC8GDrtDI5U4Y30l1UP1749053598.mp3", "video": ""}, {"text": "A 65 y/o male with a history of coronary artery disease presents with hypertension resistant to medication. A Doppler ultrasound shows a renal artery to proximal aorta ratio (RAR) of 4:1 and a peak systolic velocity (PSV) of 250 cm/s. What is the most likely cause of these findings?", "options": [{"label": "A", "text": "Ureteral obstruction", "correct": false}, {"label": "B", "text": "Fibromuscular dysplasia", "correct": false}, {"label": "C", "text": "Renal vein thrombosis", "correct": false}, {"label": "D", "text": "Renal artery stenosis", "correct": true}], "correct_answer": "D. Renal artery stenosis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/5Y14DfNhrO4HZPHItlwx1744032750.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p style=\"text-align:center\"><strong>Renal <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">Artery</span> Stenosis</strong></p>\n<p style=\"text-align:center\"><strong>(Option D)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p style=\"text-align:center\"><strong>Fibromuscular Dysplasia</strong></p>\n<p style=\"text-align:center\"><strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>⢠Narrowing of the arteries that supply blood to the kidneys.</p>\n<p>⢠Common Causes:</p>\n<ul>\n<li>Atherosclerosis (most common, especially in elderly patients).</li>\n<li>Fibromuscular <span class=\"customMeta\" data-dictid=\"984733db481692777186757cce6e6b\">Dysplasia</span> (FMD) (second most common, more frequent in young females).</li>\n</ul>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠The second most common cause of RAS after atherosclerosis.</p>\n<p>⢠Typically affects middle to <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> arteries. More common in young females and often affects both kidneys.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Doppler <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">Ultrasound</span> Signs of RAS</strong>:</p>\n<p><strong>Direct signs</strong>:</p>\n<p><strong>⢠PSV &gt; 180 cm/s.</strong></p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> to <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> <span class=\"customMeta\" data-dictid=\"ce68eab48a1692777181c719b4344e\">aorta</span> ratio (RAR) &gt; 3.5:1.</strong></p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"de3e9d9ea8169277718195a8111674\">Aliasing</span> artefacts and lack of <span class=\"customMeta\" data-dictid=\"eb476e70a316927771861ad68beaae\">Doppler</span> signals.</p>\n<p><strong>Indirect signs</strong>:</p>\n<p>Acceleration time &gt; 70 ms. (Time from the start of <span class=\"customMeta\" data-dictid=\"13941ea4ec1692777199fc8cfd1a7a\">systole</span> to peak systole)</p>\n<p>Turbulent flow with <span class=\"customMeta\" data-dictid=\"ccea7fb8c61692777198ee9aeb76dd\">spectral</span> broadening and increased <span class=\"customMeta\" data-dictid=\"8459151fee1692777197d1ac765aa0\">resistive</span> index.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>\"String of beads\" pattern, showing <span class=\"customMeta\" data-dictid=\"1b5a7ceea716927771815e7283e571\">alternating</span> narrowings and dilatations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Doppler showing elevated PSV at 366 cm/s\" data-author=\"Charlie Chia-Tsong Hsu\" data-hash=\"7953\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/renal-artery-stenosis-6#image-8981354\" data-tags=\"April2025\" height=\"249\" src=\"https://image.prepladder.com/notes/5Y14DfNhrO4HZPHItlwx1744032750.png\" width=\"350\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT shows a beaded appearance on the right &lt;span class=\" custommeta\"=\"\" data-dictid=\"b9356afdba16927771979d068c6587\"/>renal artery-Fibromuscular Dysplasia\" data-author=\"Pierre-François Plouin, JĂŠrĂ´me Perdu, Agnès La Batide-Alanore, Pierre Boutouyrie, Anne-Paule Gimenez-Roqueplo, Xavier Jeunemaitre\" data-hash=\"7954\" data-license=\"CC BY 2.0\" data-source=\"https://en.wikipedia.org/wiki/Fibromuscular_dysplasia#/media/File:Fibr.jpg\" data-tags=\"April2025\" height=\"215\" src=\"https://image.prepladder.com/notes/l7tPwtjdFVrLtOkMVYtN1744032766.png\" width=\"350\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CT <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (CTA) and MR <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (MRA)</strong>: Provide detailed <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> views of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> arteries and surrounding structures.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Contrast Enhanced MR &lt;span class=\" custommeta\"=\"\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\"/>Angiography showing <span class=\"customMeta\" data-dictid=\"0c9567c6cb16927771996c6bc2b21e\">stenosis</span> of the Right <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Artery.\" data-author=\"Roberto Schubert\" data-hash=\"7955\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/renal-artery-stenosis-1#image-1104784\" data-tags=\"April2025\" height=\"225\" src=\"https://image.prepladder.com/notes/7oLov2ZUPUMwLO8PTg481744033097.png\" width=\"350\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bifGYqNOlyZECAv5VUsL1749053813.mp3", "video": ""}, {"text": "A 45 y/o patient with a history of diabetes and prolonged analgesic use presents with signs of acute renal failure. A CT urography shows deformed calyces and filling defects in the pelvicalyceal system. What is the likely cause of the filling defects seen in this patient?", "options": [{"label": "A", "text": "Necrosed papilla", "correct": true}, {"label": "B", "text": "Medullary sponge kidney", "correct": false}, {"label": "C", "text": "Ureteral stricture", "correct": false}, {"label": "D", "text": "Vesicoureteric reflux", "correct": false}], "correct_answer": "A. Necrosed papilla", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5qheZh2VWDaXedmVhwHr1749053997.mp3", "video": ""}, {"text": "A 6-month-old infant is evaluated for an abdominal mass found during a routine examination. An ultrasound reveals large cysts in the kidney and it appears predominantly cystic with little to no identifiable renal parenchyma. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Autosomal recessive polycystic kidney disease (ARPKD)", "correct": false}, {"label": "B", "text": "Multicystic dysplastic kidney (MCDK)", "correct": true}, {"label": "C", "text": "Autosomal dominant polycystic kidney disease (ADPKD)", "correct": false}, {"label": "D", "text": "Simple renal cysts", "correct": false}], "correct_answer": "B. Multicystic dysplastic kidney (MCDK)", "question_images": ["https://image.prepladder.com/notes/epprKgQFcwJd30OMYxMN1744031680.png"], "explanation_images": ["https://image.prepladder.com/notes/O8Y8yqXz1f11cK9JNFGj1744031720.png", "https://image.prepladder.com/notes/MOjGHAhLVZcphVO3fr1m1744031871.png", "https://image.prepladder.com/notes/wsM1dOBGQfPiOQB3pSSk1744031887.png", "https://image.prepladder.com/notes/iASWaz2srtIWS0oeTIUx1744031900.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Plain <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> <span class=\"customMeta\" data-dictid=\"5c71603ac81692777197e2aa1e7fd3\">radiograph</span> showing B/L <span class=\"customMeta\" data-dictid=\"316968b3e116927772021379938005\">flank</span> mass</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>USG showing ARPKD</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Striated <span class=\"customMeta\" data-dictid=\"a5162d95c51692777193af37d8cdb4\">nephrogram</span> on CT</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Recessive polycystic kidney disease Plain abdominal x ray\" data-author=\"Gael J. Lonergan, Roy R. Rice, Eric S. Suarez\" data-hash=\"7944\" data-license=\"NA\" data-source=\"https://pubs.rsna.org/doi/abs/10.1148/radiographics.20.3.g00ma20837?journalCode=radiographics\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/MOjGHAhLVZcphVO3fr1m1744031871.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"USG showing ARPKD\" data-author=\"Patel, Narrotam &amp; Suthar, Pokhraj.\" data-hash=\"7945\" data-license=\"CC BY-NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/ARPKD-Sagittal-sonogram-shows-multiple-micro-cysts-in-the-right-kidney-which-are-not_fig20_264535567\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/wsM1dOBGQfPiOQB3pSSk1744031887.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Striated nephrogram on CT\" data-author=\"Irfan Moinuddin, Erika Bracamonte, Bijin Thajudeen, Amy Sussman, Machaiah Madhrira, James Costello\" data-hash=\"7946\" data-license=\"CC BY 3.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1155/2015/250530\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/iASWaz2srtIWS0oeTIUx1744031900.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old woman, with a family history of renal disease, presents with hematuria and hypertension. She has a history of recurrent flank pain and is currently diagnosed with renal failure. Ultrasound imaging is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Simple renal cysts", "correct": false}, {"label": "B", "text": "Autosomal dominant polycystic kidney disease (ADPKD)", "correct": true}, {"label": "C", "text": "Multicystic dysplastic kidney", "correct": false}, {"label": "D", "text": "Renal cell carcinoma", "correct": false}], "correct_answer": "B. Autosomal dominant polycystic kidney disease (ADPKD)", "question_images": ["https://image.prepladder.com/notes/8vtmSR5i2CnPVXkarQ0n1744032106.png"], "explanation_images": ["https://image.prepladder.com/notes/oLbf4roarbHKYuzmji8K1744032123.png", "https://image.prepladder.com/notes/dWvlfzjoYWAazuYOSJr91744032143.png", "https://image.prepladder.com/notes/iPpjhqcz2jvDorKvrkbO1744032158.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Plain Radiograph</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Enlarged, multilobulated <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> outlines with <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> displacement.</p>\n<p>⢠Multiple calcifications, sometimes with multiple ring appearance.</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">Intravenous</span> urography</strong>: \"Swiss cheese nephrogram\" (due to multiple <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> cysts), \"Spiderleg pyelogram\" (stretched <span class=\"customMeta\" data-dictid=\"3cc82f8bfb1692777195602cfccef5\">pelvicalyceal</span> system).</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"adpkd swiss cheese nephrogram\" data-author=\"Moreira, Ana Sofia &amp; Castro, Miguel &amp; Grande, Pablo &amp; Gameiro, Ana &amp; Bahia Soares, Carla &amp; Costa, Yessica &amp; Silva, LuĂs &amp; Saraiva, JosĂŠ &amp; Dinis, MĂłnica.\" data-hash=\"7948\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/Swiss-Cheese-Appearance-Renal-ultrasound-showing-polycystic-kidneys-in-a-patient-with_fig3_314914201\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/oLbf4roarbHKYuzmji8K1744032123.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Ultrasound</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Simple cysts: <span class=\"customMeta\" data-dictid=\"acb59b05f31692777181d2df5f618b\">Anechoic</span> with thin walls, <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> enhancement, and <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> shadowing.</p>\n<p>⢠Complicated cysts (haemorrhage/infection): <span class=\"customMeta\" data-dictid=\"91b98150ea169277718629280d911c\">Echogenic</span> material within the cyst, possible wall calcification, absence of internal blood flow.</p>\n<p><strong>⢠CEUS</strong>: Demonstrates enhancement</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"USG of &lt;span class=\" custommeta\"=\"\" data-dictid=\"b9356afdba16927771979d068c6587\"/>Renal <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">Cystic</span> lesions- ADPKD\" data-author=\"Kristoffer Lindskov Hansen, Michael Bachmann Nielsen and Caroline Ewertsen\" data-hash=\"7947\" data-license=\"CC BY 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Advanced_polycystic_kidney_disease_with_multiple_cysts.jpg\" data-tags=\"April2025\" height=\"398\" src=\"https://image.prepladder.com/notes/8vtmSR5i2CnPVXkarQ0n1744032106.png\" width=\"500\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CT</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Simple cysts: Rounded with near-water <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> and thin walls.</p>\n<p>⢠Complications (haemorrhage/infection): Higher <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> and wall calcification.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT showing ADPKD\" data-author=\"Yamada, Yasutoshi &amp; Enokida, Hideki &amp; Mitsuke, Akihiko &amp; Nishimura, Hiroaki &amp; Tatarano, Shuichi &amp; Nakagawa, Masayuki.\" data-hash=\"7949\" data-license=\"CC BY-NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/Preoperative-CT-Preoperative-CT-showing-large-polycystic-kidneys-occupying-the-pelvis_fig1_334567994\" data-tags=\"April2025\" height=\"674\" src=\"https://image.prepladder.com/notes/dWvlfzjoYWAazuYOSJr91744032143.png\" width=\"500\">\n<figcaption>{{caption_text}}</figcaption>\n</img></figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>MRI</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠T2 MRI- The most sensitive <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> modality</p>\n<p>⢠Both enlarged kidneys have multiple cysts</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"MRI showing ADPKD\" data-author=\"Brisbane\" data-hash=\"7950\" data-license=\"CC BY 4.0\" data-source=\"https://www.ncbi.nlm.nih.gov/books/NBK373387/figure/fig4_1/\" data-tags=\"April2025\" height=\"409\" src=\"https://image.prepladder.com/notes/iPpjhqcz2jvDorKvrkbO1744032158.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45 y/o woman presents with a family history of renal cell carcinoma, along with multiple skin lesions resembling fibrofolliculomas. She also reports episodes of spontaneous pneumothorax. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Angiomyolipoma", "correct": false}, {"label": "B", "text": "Oncocytoma", "correct": false}, {"label": "C", "text": "Birt-Hogg-DubĂŠ syndrome", "correct": true}, {"label": "D", "text": "Tuberous sclerosis", "correct": false}], "correct_answer": "C. Birt-Hogg-DubĂŠ syndrome", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/4XHm9DHBgkAV6OBSEwLK1744031142.png", "https://image.prepladder.com/notes/bJhlP6kSpawnV4M8aVa51744031158.png", "https://image.prepladder.com/notes/RPXy711Iomp8DjpaPYub1744031171.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Fibrofolliculomas\" data-author=\"Madhero88\" data-hash=\"7938\" data-license=\"CC BY-SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Fibrofolliculoma#/media/File:Birt%E2%80%93Hogg%E2%80%93Dub%C3%A9_syndrome.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/4XHm9DHBgkAV6OBSEwLK1744031142.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT scan showing &lt;span class=\" custommeta\"=\"\" data-dictid=\"b9356afdba16927771979d068c6587\"/>Renal cell carcinoma\" data-author=\"Dr Radhiana Hassan\" data-hash=\"7937\" data-license=\"NA\" data-source=\"https://radiologycases.my/2021/05/20/incidental-findings-of-renal-cell-carcinoma/\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/3edR4A5fWEGyNqhDqNKw1744030961.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Birt Hogg Dube syndrome\" data-author=\"Yang, Jinjing &amp; Hu, Xiaowen &amp; Li, Junjun &amp; Zhang, Guofeng &amp; Ge, Yaqiong &amp; Wei, Wei.\" data-hash=\"7939\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Chest-CT-images-of-patients-diagnosed-with-BHD-syndrome-Multiple-lung-cysts-ofvarying_fig4_358407147\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/bJhlP6kSpawnV4M8aVa51744031158.png\">\n<figcaption>{{caption_text}}</figcaption>\n</img></figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Fibrofolliculomas:</strong></p>\n<p>Papulous skin lesions</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Renal Cell Carcinoma</strong></p>\n<p>CT showing <span class=\"customMeta\" data-dictid=\"11309a56bc1692777189e89a8d3041\">hypodense</span> lesions in the kidney.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Lung cysts on <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> CT</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 62 y/o female patient presents with hematuria and flank pain. A CECT scan reveals a solid hyper-enhancing renal mass measuring 5 cm. The radiologist notes heterogeneous enhancement and suggests further evaluation for possible extension into the inferior vena cava (IVC). Which of the following imaging modalities is the most appropriate next step to evaluate for potential IVC extension or thrombus?", "options": [{"label": "A", "text": "Contrast-enhanced ultrasound", "correct": false}, {"label": "B", "text": "Contrast-enhanced CT", "correct": false}, {"label": "C", "text": "Contrast MRI", "correct": true}, {"label": "D", "text": "Plain abdominal X-ray", "correct": false}], "correct_answer": "C. Contrast MRI", "question_images": ["https://image.prepladder.com/notes/OQMGmyFGQxEKFZyE7Hj01744030943.png"], "explanation_images": ["https://image.prepladder.com/notes/OQMGmyFGQxEKFZyE7Hj01744030943.png", "https://image.prepladder.com/notes/3edR4A5fWEGyNqhDqNKw1744030961.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45 y/o male undergoes an imaging study for evaluation of flank pain. A CECT scan reveals a renal cyst with multiple hairline thin septa and minimal wall thickening. The cyst shows thick nodular calcifications but no measurable enhancement after contrast administration. Based on the Bosniak classification, which of the following management options is most appropriate for this patient?", "options": [{"label": "A", "text": "No follow-up is needed; continue routine monitoring.", "correct": false}, {"label": "B", "text": "Follow-up imaging every 6 months for 1 year.", "correct": true}, {"label": "C", "text": "Surgical excision or ablation of the cyst.", "correct": false}, {"label": "D", "text": "Follow-up imaging every 6 weeks for 1 year.", "correct": false}], "correct_answer": "B. Follow-up imaging every 6 months for 1 year.", "question_images": ["https://image.prepladder.com/notes/BdSMbw7eUzUpynXquRBN1744030533.png"], "explanation_images": [], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Category I</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Simple cyst, fluid density, hairline thin wall.</p>\n<p>⢠No septa, calcifications, or solid components.</p>\n<p>⢠No <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> post-intravenous contrast.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Category I-Bosniak &lt;span class=\" custommeta\"=\"\" data-dictid=\"dda6ab11271692777184264b752d39\"/>Classification of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Cysts\" data-author=\"Tariq Walizai\" data-hash=\"7931\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/bosniak-classification-system-of-renal-cystic-masses-version-2005-1\" data-tags=\"April2025\" height=\"300\" src=\"https://image.prepladder.com/notes/eHq4dQswilwd8l2wXkm71744030565.png\" width=\"400\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>CT showing a simple cyst.</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠No follow-up is required.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Category II</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠<span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">Cyst</span> with some hairline thin septa, and fine calcifications.</p>\n<p>⢠Uniformly high-density (&lt;3 cm).</p>\n<p>⢠No measurable enhancement.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Category II-Bosniak &lt;span class=\" custommeta\"=\"\" data-dictid=\"dda6ab11271692777184264b752d39\"/>Classification of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Cysts\" data-author=\"Tariq Walizai\" data-hash=\"7932\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/bosniak-classification-system-of-renal-cystic-masses-version-2005-1\" data-tags=\"April2025\" height=\"353\" src=\"https://image.prepladder.com/notes/CwQVq8oe1ThsabRkV6Ln1744030581.png\" width=\"400\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>CT showing hairline <span class=\"customMeta\" data-dictid=\"d983a6cd671692777198ec423b3b90\">septa</span> and fine calcifications</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠No follow-up is required.</p>\n<p>⢠US or CT may be sufficient for characterisation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Category IIF</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Multiple hairline thin septa, minimal wall/septa thickening.</p>\n<p>⢠Thick <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> calcifications or uniformly high-density (&gt;3 cm).</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"0c7efd2b8716927771914c8cb19e54\">Malignancy</span> Risk</strong>: ~20%</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\" CT findings describe a &lt;span class=\" custommeta\"=\"\" data-dictid=\"b9356afdba16927771979d068c6587\"/>renal <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> with multiple hairline thin septa\" data-author=\"Agnello, Francesco &amp; Albano, Domenico &amp; Micci, Giuseppe &amp; Buono, Giuseppe &amp; Agrusa, Antonino &amp; Salvaggio, Giuseppe &amp; Pardo, Salvatore &amp; Sparacia, Gianvincenzo &amp; Bartolotta, Tommaso &amp; Midiri, Massimo &amp; Lagalla, Roberto &amp; Galia, Massimo.\" data-hash=\"7929\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Bosniak-category-IIF-renal-cyst-Axial-non-enhanced-CT-image-shows-a-lesion-with_fig2_338383037\" data-tags=\"April2025\" height=\"541\" src=\"https://image.prepladder.com/notes/05QeG0OCgqlaCqmhUcp11744030462.png\" width=\"450\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Follow-up</strong>:</p>\n<p>⌠Every 6 months for 1 year with CT or MRI.</p>\n<p>⌠Followed by <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> done annually for at least the next 5 years.</p>\n<p>⌠May progress to Category III or IV.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Category III</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Thickened, irregular, or smooth enhancing walls/septa.</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"0c7efd2b8716927771914c8cb19e54\">Malignancy</span> Risk</strong>: ~50%</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Category III-Bosniak &lt;span class=\" custommeta\"=\"\" data-dictid=\"dda6ab11271692777184264b752d39\"/>Classification of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Cysts\" data-author=\"Tariq Walizai\" data-hash=\"7933\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/bosniak-classification-system-of-renal-cystic-masses-version-2005-1\" data-tags=\"April2025\" height=\"289\" src=\"https://image.prepladder.com/notes/7smtokvLyl3S9UFkrJcX1744030596.png\" width=\"400\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>CT showing thickened septa</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Treatment</strong>: <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">Surgical</span> excision/ablation due to high <span class=\"customMeta\" data-dictid=\"0c7efd2b8716927771914c8cb19e54\">malignancy</span> risk.</p>\n<p><strong>⢠Imaging</strong>:</p>\n<p>⌠Contrast-enhanced <span class=\"customMeta\" data-dictid=\"b064ad04421692777200eae963fa27\">triphasic</span> CT for follow-up.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Category IV</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Same as Category III with additional soft-tissue components independent of walls/septa.</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"0c7efd2b8716927771914c8cb19e54\">Malignancy</span> Risk</strong>: ~90%</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Category IV-Bosniak &lt;span class=\" custommeta\"=\"\" data-dictid=\"dda6ab11271692777184264b752d39\"/>Classification of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Cysts\" data-author=\"Tariq Walizai\" data-hash=\"7934\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/bosniak-classification-system-of-renal-cystic-masses-version-2005-1\" data-tags=\"April2025\" height=\"285\" src=\"https://image.prepladder.com/notes/oiN2wlgQjOREUP34WsqO1744030613.png\" width=\"400\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>CT showing thickened <span class=\"customMeta\" data-dictid=\"d983a6cd671692777198ec423b3b90\">septa</span> with additional soft tissue components</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Treatment</strong>: <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">Surgical</span> excision/ablation is recommended.</p>\n<p><strong>⢠Imaging</strong>: Same protocol as Category III for <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> with <span class=\"customMeta\" data-dictid=\"b064ad04421692777200eae963fa27\">triphasic</span> CT.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ZdWBjLsnXno43gLNdUVc1749050022.mp3", "video": ""}, {"text": "A 2 y/o child presents with abdominal distension and a palpable abdominal mass. A CT scan is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Wilms Tumor (Nephroblastoma)", "correct": false}, {"label": "B", "text": "Neuroblastoma", "correct": true}, {"label": "C", "text": "Renal Cell Carcinoma", "correct": false}, {"label": "D", "text": "Hepatoblastoma", "correct": false}], "correct_answer": "B. Neuroblastoma", "question_images": ["https://image.prepladder.com/notes/Tgce9T4DL6IL3t7TCn3h1744029974.png"], "explanation_images": ["https://image.prepladder.com/notes/jsTBO6O0aS7r2H1Yc2l71744029992.png", "https://image.prepladder.com/notes/Tgce9T4DL6IL3t7TCn3h1744029974.png"], "explanation": "<table align=\"left\" cellpadding=\"0\" cellspacing=\"0\" style=\"width:89%\">\n<thead>\n<tr>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Wilms Tumor (Nephroblastoma)</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Neuroblastoma</strong></p>\n</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Calcification</strong>: Uncommon (10-15%)</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">Vascular</span> involvement</strong>: Displaces <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> vessels but does not encase them</p>\n<p><strong>⢠Age group</strong>: Slightly older (peak at 3-4 years)</p>\n<p><strong>⢠Margins</strong>: Well-circumscribed</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"c2193cdaa816927771843863690961\">Claw</span> sign</strong>: <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">Kidney</span> <span class=\"customMeta\" data-dictid=\"c2193cdaa816927771843863690961\">claw</span> sign present</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">Vascular</span> extension</strong>: Common into IVC/renal vein</p>\n<p><strong>⢠Midline crossing</strong>: Does not cross midline</p>\n<p><strong>⢠Bone metastases</strong>: Rare, lung <span class=\"customMeta\" data-dictid=\"ee33485c641692777192b16b999489\">metastases</span> are common</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">Spinal</span> <span class=\"customMeta\" data-dictid=\"371930068716927771839cba840631\">canal</span> extension</strong>: Never seen</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"5d0f37715816927771973ecda21336\">Retroperitoneal</span> <span class=\"customMeta\" data-dictid=\"4df97a6cbf169277719172fd1af767\">lymph</span> nodes</strong>: Uncommon</p>\n<p><strong>⢠Hemorrhage</strong>: Higher incidence</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT showing Wilms tumour\" data-author=\"Dumba, Maureen &amp; Jawad, Noorulhuda &amp; Mchugh, Kieran.\" data-hash=\"7928\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Axial-CT-of-a-3year-old-boy-with-right-sided-Wilms-tumour-again-demonstrating-the-claw_fig4_275101515\" data-tags=\"April2025\" height=\"186\" src=\"https://image.prepladder.com/notes/jsTBO6O0aS7r2H1Yc2l71744029992.png\" width=\"220\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Calcification</strong>: Very common</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">Vascular</span> involvement</strong>: Encases but does not invade vessels</p>\n<p><strong>⢠Age group</strong>: Younger (&lt;2 years)</p>\n<p><strong>⢠Margins</strong>: Poorly marginated</p>\n<p><strong>⢠Aorta</strong>: Elevates <span class=\"customMeta\" data-dictid=\"ce68eab48a1692777181c719b4344e\">aorta</span> away from the vertebral column</p>\n<p><strong>⢠Midline crossing</strong>: Frequently crosses the midline, especially behind the aorta</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"3c6021096816927772007954fcc158\">Thoracic</span> extension</strong>: Common</p>\n<p><strong>⢠Bone metastases</strong>: Common (Hutchinson syndrome)</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">Spinal</span> <span class=\"customMeta\" data-dictid=\"371930068716927771839cba840631\">canal</span> extension</strong>: Can occur</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"5d0f37715816927771973ecda21336\">Retroperitoneal</span> <span class=\"customMeta\" data-dictid=\"4df97a6cbf169277719172fd1af767\">lymph</span> nodes</strong>: Common</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"neuroblastoma\" data-author=\"Frank Gaillard\" data-hash=\"7927\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/neuroblastoma-8#image-484652\" data-tags=\"April2025\" height=\"156\" src=\"https://image.prepladder.com/notes/Tgce9T4DL6IL3t7TCn3h1744029974.png\" width=\"220\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fh8fj3N72FkTnmY0bzXt1747840457.mp3", "video": ""}, {"text": "A 42-year-old male presents to the emergency department with severe pelvic pain after a motor vehicle collision. CT cystogram of the patient is given below. What type of injury is most likely responsible for the patient's symptoms?", "options": [{"label": "A", "text": "Intraperitoneal bladder rupture", "correct": false}, {"label": "B", "text": "Extraperitoneal bladder rupture", "correct": true}, {"label": "C", "text": "Bulbous urethra rupture", "correct": false}, {"label": "D", "text": "Membranous urethra rupture", "correct": false}], "correct_answer": "B. Extraperitoneal bladder rupture", "question_images": ["https://image.prepladder.com/notes/UWZuJYMBcF7UuTiFKwIK1744029673.png"], "explanation_images": ["https://image.prepladder.com/notes/cBh06gfePtuxoGeBdUKS1744029688.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Extra Peritoneal <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> rupture</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Intra Peritoneal <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> rupture</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>⢠Caused by <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> fractures and rapid deceleration.</p>\n<p>⢠Leakage into thighs, perineum, penis, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> wall.</p>\n<p>⢠Commonly associated with <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> fractures.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Extraperitoneal &lt;span class=\" custommeta\"=\"\" data-dictid=\"e6cfda323816927771839cc83e376d\"/>bladder rupture-molar tooth sign\" data-author=\"Haroon, Samir &amp; Rahimi, Hamza &amp; Merritt, Alexander &amp; Baghdanian, Arthur &amp; Baghdanian, Armonde &amp; LeBedis, Christina.\" data-hash=\"7925\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/a-b-Molar-tooth-sign-39-year-old-man-after-fall-from-a-roof-Axial-a-and-sagittal_fig9_335680851\" data-tags=\"April2025\" height=\"629\" src=\"https://image.prepladder.com/notes/8NYz1Yg8VphanoeAR6zD1744029707.png\" width=\"400\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p>⢠The <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> molar tooth sign refers to contrast media leaking from the <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> and accumulating in the <span class=\"customMeta\" data-dictid=\"707b8e89cd1692777196474be04ff0\">preperitoneal</span> space, creating a molar tooth-shaped appearance on CT <span class=\"customMeta\" data-dictid=\"f28b2fb03516927771853498063d8e\">cystography</span> after <span class=\"customMeta\" data-dictid=\"1f0a3237f21692777187669004cf0a\">extraperitoneal</span> <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> rupture.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Occurs at the <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> dome, above the peritoneal reflection.</p>\n<p>⢠Caused by a direct blow to a distended bladder.</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">Urine</span> leakage into the abdomen; causes <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> derangements.</p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT cystogram demonstrates the classic appearance of an &lt;span class=\" custommeta\"=\"\" data-dictid=\"e47e248094169277719000b0ed02ea\"/>intraperitoneal rupture\" data-author=\"Vaccaro, Jonathan P. and Jeffrey M. Brody\" data-hash=\"7926\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/CT-cystography-in-the-evaluation-of-major-bladder-Vaccaro-Brody/5170367349da5d43e553d56097d8e85b2b49488b/figure/1\" data-tags=\"April2025\" height=\"480\" src=\"https://image.prepladder.com/notes/pUOneSPH36DZfAuJYuAm1744029721.png\" width=\"550\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qBSZbYiTgEfczepqtRJ81747761287.mp3", "video": ""}, {"text": "A 35-year-old male presents with difficulty urinating and a history of profuse, creamy urethral discharge. He reports a prior untreated sexually transmitted infection. The urethrogram of the patient is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Urethral carcinoma", "correct": false}, {"label": "B", "text": "Bulbar urethral stricture", "correct": true}, {"label": "C", "text": "Penile urethral stricture", "correct": false}, {"label": "D", "text": "Benign prostatic hyperplasia", "correct": false}], "correct_answer": "B. Bulbar urethral stricture", "question_images": ["https://image.prepladder.com/notes/KkMNm0t6ybMeW50iCXRE1744029442.png"], "explanation_images": ["https://image.prepladder.com/notes/U9Tn61gRpy1jVK3whIXD1744029463.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Bulbar urethral stricture</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Retrograde urethrogram showing &lt;span class=\" custommeta\"=\"\" data-dictid=\"ef00544aba1692777183bc916b1c30\"/>bulbar urethral stricture\" data-author=\"Bassem S Wadie\" data-hash=\"7920\" data-license=\"CC BY 3.0\" data-source=\"https://www.researchgate.net/figure/Retrograde-urethrogram-showing-bulbar-urethral-stricture_fig3_382221540\" data-tags=\"April2025\" height=\"332\" src=\"https://image.prepladder.com/notes/KkMNm0t6ybMeW50iCXRE1744029442.png\" width=\"400\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p>⢠<span class=\"customMeta\" data-dictid=\"329b77e4b11692777199930404f75c\">Stricture</span> seen in the <span class=\"customMeta\" data-dictid=\"ef00544aba1692777183bc916b1c30\">bulbar</span> urethra.</p>\n<p>⢠Common in gonorrhoea.</p>\n<p>⢠Presents with profuse, <span class=\"customMeta\" data-dictid=\"0c02372a7d1692777196974ab1d772\">purulent</span> or <span class=\"customMeta\" data-dictid=\"66d0cfdc741692777193d2b4fe3249\">mucopurulent</span> urethral discharge.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Stricture of <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> penile urethra</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Stricture of &lt;span class=\" custommeta\"=\"\" data-dictid=\"5ff25303a01692777186731f6a4f5c\"/>distal penile urethra-urethrogram\" data-author=\"Keshavam Hospital\" data-hash=\"7922\" data-license=\"NA\" data-source=\"https://keshavamhospital.com/stricture-urethra.php\" data-tags=\"April2025\" height=\"248\" src=\"https://image.prepladder.com/notes/xGEp0ML3eUGOR7mtiLFX1744029479.png\" width=\"400\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p>⢠Urethrogram showing narrowing in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> urethra.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is true regarding the indications for Voiding Cystourethrography (VCUG) and Retrograde Urethrography (RUG)?", "options": [{"label": "A", "text": "VCUG is the gold standard for evaluating urethral strictures.", "correct": false}, {"label": "B", "text": "RUG is the gold standard for detecting vesicoureteral reflux (VUR).", "correct": false}, {"label": "C", "text": "VCUG is the most important modality for examining urinary tract anomalies in children.", "correct": true}, {"label": "D", "text": "Blood at the urethral meatus is a key indicator for performing VCUG.", "correct": false}], "correct_answer": "C. VCUG is the most important modality for examining urinary tract anomalies in children.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/kUzJML0Zl3lHblv4z6dt1744019979.png", "https://image.prepladder.com/notes/fXdroDQMsemrpnMMiEd61744019996.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p style=\"text-align:center\"><strong>Voiding <span class=\"customMeta\" data-dictid=\"c65af338d916927771853b83a9c9c5\">Cystourethrography</span> (VCUG)/ Micturating <span class=\"customMeta\" data-dictid=\"7d3833cfbf1692777185c44c246cf4\">Cystourethrogram</span> (MCUG)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p style=\"text-align:center\"><strong>Retrograde <span class=\"customMeta\" data-dictid=\"adb08c51431692777201ab86e23b39\">Urethrography</span> (RUG)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>⢠<span class=\"customMeta\" data-dictid=\"1fbf40a1d316927772018a8e73e615\">VCUG</span> is a fluoroscopic procedure used to assess the <span class=\"customMeta\" data-dictid=\"9e99effc421692777181b02606e021\">anatomy</span> and function of the <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> and urethra, primarily to detect <span class=\"customMeta\" data-dictid=\"2b8a1464c91692777201a347e52ce5\">vesicoureteral</span> <span class=\"customMeta\" data-dictid=\"def94cc96d16927771970d1a5cfb71\">reflux</span> (VUR). <strong>(Option B ruled out)</strong></p>\n<p>⢠The most important <span class=\"customMeta\" data-dictid=\"2333eb40ca16927771925442e26719\">modality</span> for urological examination in children.</p>\n<p>⢠MCUG is the gold standard for evaluating VUR.</p>\n<p>⢠VUR is the <span class=\"customMeta\" data-dictid=\"e38ca8e6931692777197ee6a68ac56\">retrograde</span> passage of <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> from the <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> into the <span class=\"customMeta\" data-dictid=\"8cde7563da1692777201fca2b1f090\">ureter</span> and potentially the calyces.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠A <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> procedure used to accurately diagnose, stage, and delineate urethral strictures.</p>\n<p><strong>⢠The gold standard in the management of urethral <span class=\"customMeta\" data-dictid=\"329b77e4b11692777199930404f75c\">stricture</span> disease</strong>. <strong>(Option A ruled out)</strong></p>\n<p>⢠Can be combined with voiding <span class=\"customMeta\" data-dictid=\"7d3833cfbf1692777185c44c246cf4\">cystourethrogram</span> (VCUG) for better <span class=\"customMeta\" data-dictid=\"33ba8d60fb16927772029d1067e602\">visualization</span> of complex cases.</p>\n<p>⢠Contrast media is <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> retrogradely into the urethra, followed by a series of radiographs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Indications:</strong></p>\n<p>⢠Anomalies of the <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> tract: <strong>(Option C)</strong></p>\n<p>⌠<span class=\"customMeta\" data-dictid=\"a5d2b7108116927771811311422c5c\">Anorectal</span> malformation.</p>\n<p>⌠Myelodysplasia.</p>\n<p>⌠Prune-belly syndrome.</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"e57922b3c91692777202151895d37e\">Febrile</span> <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infection (particularly if recurrent).</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"441df40d111692777189b0e31acb06\">Hydronephrosis</span> or hydroureter.</p>\n<p>⢠Hematuria.</p>\n<p>⢠Voiding abnormalities:</p>\n<p>⌠Dysuria.</p>\n<p>⌠Dysfunctional voiding (neurogenic bladder).</p>\n<p>⌠Incontinence.</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">Neonatal</span> ascites.</p>\n<p>⢠Trauma.</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">Postoperative</span> evaluation of the <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> tract.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Indications:</strong></p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">Pelvic</span> trauma with suspicion of urethral injury.</p>\n<p>⢠Urethral obstruction.</p>\n<p>⢠Foreign bodies in the urethra.</p>\n<p>⢠Urethral diverticula.</p>\n<p>⢠Suspected urethral fistula.</p>\n<p>⢠Blood at the urethral <span class=\"customMeta\" data-dictid=\"6da3f0528c1692777192e9b608d735\">meatus</span> is a key indicator for testing. <strong>(Option D ruled out)</strong></p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"e5d34563e91692777183da2015189e\">Catheter</span> placement should be withheld until RUG to prevent worsening injury.</p>\n<p>⢠Evaluation for rectal trauma and checking for a high-riding <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">prostate</span> is essential.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"MCU Anterior Diverticulum\" data-author=\"\" data-hash=\"7868\" data-license=\"CC BY NC SA 3.0\" data-source=\"https://openi.nlm.nih.gov/detailedresult?img=PMC4586986_JIAPS-20-198-g001&amp;query=micturating%20cystourethrogram&amp;it=xg&amp;req=4&amp;npos=8\" data-tags=\"April2025\" height=\"651\" src=\"https://image.prepladder.com/notes/kUzJML0Zl3lHblv4z6dt1744019979.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Normal RGU\" data-author=\"Ramanathan, Subramaniyan &amp; Raghu, Vineetha &amp; Ramchandani, Parvati.\" data-hash=\"7869\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Normal-urethral-anatomy-a-Retrograde-urethrogram-shows-the-anatomical-landmarks-The_fig7_337930320\" data-tags=\"April2025\" height=\"603\" src=\"https://image.prepladder.com/notes/fXdroDQMsemrpnMMiEd61744019996.png\" width=\"555\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XRgpzVz0Ng0XJzgTYCDh1748781258.mp3", "video": ""}, {"text": "A 45 y/o male presents with right-sided flank pain and recurrent urinary tract infections. The imaging study is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Vesicoureteral reflux", "correct": false}, {"label": "B", "text": "Transitional cell carcinoma", "correct": false}, {"label": "C", "text": "Polycystic kidney disease", "correct": false}, {"label": "D", "text": "Retro-caval ureter", "correct": true}], "correct_answer": "D. Retro-caval ureter", "question_images": ["https://image.prepladder.com/notes/vv8NBCI6y9EdevLR666m1744026357.png"], "explanation_images": [], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\" Retro-caval &lt;span class=\" custommeta\"=\"\" data-dictid=\"8cde7563da1692777201fca2b1f090\"/>ureter answer\" data-author=\"Hani M. Al Salam\" data-hash=\"7911\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/retrocaval-ureter-1#image-208998\" data-tags=\"April2025\" height=\"470\" src=\"https://image.prepladder.com/notes/C63yQUZrNBzeL0i8V9DV1744026266.png\" width=\"350\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"X-ray Fluoroscopy showing fishhook deformity. There is right &lt;span class=\" custommeta\"=\"\" data-dictid=\"4aa6035df41692777190b41d4a1583\"/>kidney <span class=\"customMeta\" data-dictid=\"441df40d111692777189b0e31acb06\">hydronephrosis</span> and <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> of the right ureter.\" data-author=\"Mohammad Taghi Niknejad\" data-hash=\"7913\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/retrocaval-ureter-type-i-1#image-53651428\" data-tags=\"April2025\" height=\"519\" src=\"https://image.prepladder.com/notes/BUGqbdEh1EHjTl4frZnE1744026382.png\" width=\"350\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VvpAsgBsI7EpK6hNQdqp1746418781.mp3", "video": ""}, {"text": "A 35 y/o female presents with recurrent urinary tract infections and mild flank pain. An ultrasound reveals a cystic dilation near the lower ureter, and an IVU is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Ureterocele", "correct": true}, {"label": "B", "text": "Vesicoureteral reflux", "correct": false}, {"label": "C", "text": "Hydronephrosis", "correct": false}, {"label": "D", "text": "Renal calculi", "correct": false}], "correct_answer": "A. Ureterocele", "question_images": ["https://image.prepladder.com/notes/dVZ4R3ne0NtW1ShpdfnC1744025862.png"], "explanation_images": ["https://image.prepladder.com/notes/6EtCUMJ9RYjUelZGSzpv1744025914.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"vertical-align:top\">\n<p style=\"text-align:center\"><strong>Ureterocele</strong></p>\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\"> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"USG showing &lt;span class=\" custommeta\"=\"\" data-dictid=\"38c41e122116927771859b63deb0ed\"/>cystic pouching at left and right ureteral orifices\" data-author=\"Maulik S Patel\" data-hash=\"7909\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/ureterocele-bilateral#image-872455\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/DTWRMhAWrHKQol3YFANM1744025897.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p><strong> </strong></p>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"x ray showing &lt;span class=\" custommeta\"=\"\" data-dictid=\"862ec4693f16927771844445d898b3\"/>cobra head appearance\" data-author=\"Maulik S Patel\" data-hash=\"7908\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/ureterocele-bilateral#image-872455\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/HzcsceEhRAHxkplkjhCz1744025880.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KyW2rXaD8qjHVnP9rETN1745340175.mp3", "video": ""}, {"text": "Which of the following is a typical finding in the end-stage tuberculosis of the kidney, visible on abdominal radiography?", "options": [{"label": "A", "text": "Putty kidney", "correct": true}, {"label": "B", "text": "Phantom calyx", "correct": false}, {"label": "C", "text": "Sawtooth ureter", "correct": false}, {"label": "D", "text": "Hydronephrosis", "correct": false}], "correct_answer": "A. Putty kidney", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/28c5LJMOv99A4EADbVTa1744024316.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tuberculosis of the <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> tract</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Kidneys</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Renal <span class=\"customMeta\" data-dictid=\"c25071fa3816927771955eeaf9d45e\">Pelvis</span> and Calyces</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ureters</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bladder</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Calcifications:</u></strong><strong> <span class=\"customMeta\" data-dictid=\"82ded933641692777191ee421dc094\">Lobar</span> pattern and putty <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> in advanced cases.</strong></p>\n<p><u>Infundibular Strictures</u>: <span class=\"customMeta\" data-dictid=\"e51dcca7101692777195a7137db290\">Phantom</span> <span class=\"customMeta\" data-dictid=\"b8daf4c798169277718363179ec885\">calyces</span> due to <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> in early disease.</p>\n<p><strong>(Option B ruled out)</strong></p>\n<p><u>Granulomas and Abscesses</u>: Seen as <span class=\"customMeta\" data-dictid=\"11309a56bc1692777189e89a8d3041\">hypodense</span> areas on CT, <span class=\"customMeta\" data-dictid=\"5543384a9b169277718985e08cf7f8\">hypoechoic</span> on ultrasound, or <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> on MRI.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><u>Calyceal Deformities</u>: Irregular, distorted, or enlarged <span class=\"customMeta\" data-dictid=\"b8daf4c798169277718363179ec885\">calyces</span> due to strictures.</p>\n<p><u>Cavities</u>: Formed by <span class=\"customMeta\" data-dictid=\"8f88b9c691169277718754ca072062\">erosion</span> and scarring.</p>\n<p><u>Hydrocalycosis</u>: Detected on IVU and USG as <span class=\"customMeta\" data-dictid=\"b5c0ddfc46169277718391df2a6de2\">calyceal</span> dilation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><u>Strictures and Stenosis:</u> Leading to a sawtooth or <span class=\"customMeta\" data-dictid=\"db8c3d4b9e1692777182a03a530a28\">beaded</span> appearance on IVU.</p>\n<p><strong>(Option C ruled out)</strong></p>\n<p><u>Hydroureter</u>: Indicated by uneven ureteral <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">dilation</span> due to obstruction.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><u>Thimble Bladder</u>: <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">Bladder</span> <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> from fibrosis, evident on MRI.</p>\n<p><u>Bladder Wall Thickening</u>: Seen with <span class=\"customMeta\" data-dictid=\"f6ba56b89416927772009fc4bfa19a\">trabeculation</span> and <span class=\"customMeta\" data-dictid=\"0e8095312616927772017239017cd7\">ureterovesical</span> <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> involvement, causing reflux.</p>\n<br/>\n\t\t\t </td>\n</tr>\n</tbody>\n</table>\n<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT - shrunken left &lt;span class=\" custommeta\"=\"\" data-dictid=\"4aa6035df41692777190b41d4a1583\"/>kidney with calcifications (putty kidney)\" data-author=\"Ntombizakhona B.A. Mthalane-Madlala Nondumiso N.M. Dlamini\" data-hash=\"7903\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/a-and-b-Venous-phase-post-contrast-computed-tomography-CT-demonstrates-a-shrunken_fig2_323385986\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/1Uq8OsHMCXpUdJV8jXRy1744024300.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"X-ray showing right putty kidney\" data-author=\"Leung, Ting &amp; Lu, Chien-Tai &amp; Ling, Chang-Ming &amp; Lee, Chau-Chin &amp; Chang, Pau-Nyen &amp; Lee, Sea-Kiat &amp; Yen, Pao-Sheng &amp; Chou, Shou-Bin\" data-hash=\"7904\" data-license=\"CC BY-NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/Plain-kidney-ureter-and-bladder-roentgenography-shows-a-putty-right-kidney-with-atrophy_fig6_10651842\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/28c5LJMOv99A4EADbVTa1744024316.png\">\n<figcaption>{{caption_text}}</figcaption>\n</img></figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT VR(virtual reality) rendering of contracted &lt;span class=\" custommeta\"=\"\" data-dictid=\"e6cfda323816927771839cc83e376d\"/>bladder and <span class=\"customMeta\" data-dictid=\"441df40d111692777189b0e31acb06\">hydronephrosis</span> of the left kidney\" data-author=\"Praveen Jha\" data-hash=\"7905\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/tuberculosis-of-urinary-bladder#image-879979\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/XpTmLAklngICXgNnuFlM1744024331.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"USG showing thickened &lt;span class=\" custommeta\"=\"\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\"/>urinary <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> wall (thimble bladder)-TB\" data-author=\"Praveen Jha\" data-hash=\"7906\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/tuberculosis-of-urinary-bladder\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/NdlDsp71rmvHLBhG06BP1744024346.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Zw6f8vj4Lv2JyfuksbVi1748783280.mp3", "video": ""}, {"text": "A 45 y/o woman with a history of recurrent urinary tract infections presents with fever, flank pain, and weight loss. An ultrasound reveals an enlarged kidney with a large echogenic centre, and CT confirms the presence of a staghorn calculus along with renal enlargement and calyceal dilatation. What is the most likely diagnosis based on these findings?", "options": [{"label": "A", "text": "Acute pyelonephritis", "correct": false}, {"label": "B", "text": "Xanthogranulomatous pyelonephritis", "correct": true}, {"label": "C", "text": "Emphysematous pyelonephritis", "correct": false}, {"label": "D", "text": "Acute lobar nephronia", "correct": false}], "correct_answer": "B. Xanthogranulomatous pyelonephritis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/6cj2bBDrmwrkdgyHPmSl1744023869.png", "https://image.prepladder.com/notes/3Pe2EqeaC0zAL5KngtTI1744023890.png", "https://image.prepladder.com/notes/hL4Xw5oRqgU63ztspP681744023905.png", "https://image.prepladder.com/notes/ZMQMDjaCxKad69oTAmMn1744023919.png", "https://image.prepladder.com/notes/nYJF9WaB4z6hrgXmhiMi1744023937.png", "https://image.prepladder.com/notes/bR7NmeKS9EIwvWBVGMtV1744023953.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Acute Pyelonephritis</strong></p>\n<p><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Xanthogranulomatous Pyelonephritis</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Emphysematous Pyelonephritis</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Ultrasound (USG):</strong> This may show <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> enlargement, <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> echogenicity, and dilated collecting systems.</p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"USG of Acute Pyelonephritis-Hypoechoic and thickened cortex\" data-author=\"Kao, Jeff &amp; Wu, Ching-Jiunn.\" data-hash=\"7897\" data-license=\"CC BY-NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/Diffuse-acute-pyelonephritis-in-a-31-year-old-woman-A-Longitudinal-ultrasound-of-the_fig1_244858312\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/6cj2bBDrmwrkdgyHPmSl1744023869.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Ultrasound (USG):</strong> Shows an enlarged <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> with <strong>echogenic staghorn <span class=\"customMeta\" data-dictid=\"eae898f16d1692777183cc3469a664\">calculi</span> and <span class=\"customMeta\" data-dictid=\"5543384a9b169277718985e08cf7f8\">hypoechoic</span> masses</strong> replacing <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> parenchyma.</p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"USG of Xanthogranulomatous Pyelonephritis-Dilated fluid-filled spaces and calculi\" data-author=\"Ciccarese, Federica &amp; Brandi, Nicolò &amp; Corcioni, Beniamino &amp; Golfieri, Rita &amp; Gaudiano, Caterina.\" data-hash=\"7898\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Radiographic-and-ultrasonographic-US-appearance-of-xanthogranulomatous-Pyelonephritis_fig1_347212248\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/3Pe2EqeaC0zAL5KngtTI1744023890.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Plain Abdominal X-ray:</strong> Detects gas in the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> region in about 70% of cases.  </p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Emphysematous Pyelonephritis-X-ray showing gas overlying renal parenchyma\" data-author=\"Montelongo-RodrĂguez, Fred &amp; Robles-Torres, JosĂŠ &amp; GarcĂa-Saucedo, JesĂşs &amp; RuĂz-Galindo, EfraĂn &amp; Pacheco-Molina, Carlos &amp; GĂłmez-Guerra, Lauro.\" data-hash=\"7899\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Abdominal-x-ray-shows-gas-distributed-in-the-topography-of-the-right-kidney-arrows_fig1_354626047\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/hL4Xw5oRqgU63ztspP681744023905.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Contrast-enhanced CT:</strong> Most sensitive, showing wedge-shaped <span class=\"customMeta\" data-dictid=\"11309a56bc1692777189e89a8d3041\">hypodense</span> areas, <span class=\"customMeta\" data-dictid=\"83b138c27e16927771993110e65f52\">striated</span> nephrograms, and <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> wall thickening.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CECT showing striated nephrogram\" data-author=\"Irfan Moinuddin, Erika Bracamonte, Bijin Thajudeen, Amy Sussman, Machaiah Madhrira, James Costello\" data-hash=\"7900\" data-license=\"CC BY 3.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1155/2015/250530\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ZMQMDjaCxKad69oTAmMn1744023919.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>CT Scan</strong> reveals a non-functioning kidney, <strong>staghorn calculus, expanded calyces, and <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> changes</strong>. A characteristic bear <span class=\"customMeta\" data-dictid=\"27e3bff9a21692777194ab2ee09585\">paw</span> sign is noted.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT showing bear paw sign, staghorn calculus and dilated calyx\" data-author=\"Xu, Zhunan &amp; Cai, Tong &amp; Zhang, Xuebao &amp; Wu, Jitao &amp; Liu, Chu. \" data-hash=\"7901\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Bear-paw-sign-multiple-rounded-low-density-areas-with-enhancing-rings-arranged-in-a_fig1_355754695\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/nYJF9WaB4z6hrgXmhiMi1744023937.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>CT:</strong> Gold standard, reveals gas within the kidney, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> enlargement, <span class=\"customMeta\" data-dictid=\"419338f1b71692777195411fd0bfcd\">perinephric</span> stranding and abscesses. Helps classify into Type 1 (gas without fluid) or Type 2 (gas with fluid). </p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT showing air and necrotic tissue within the left kidney\" data-author=\"Dutta, Deep &amp; Ks, Shivaprasad &amp; Kumar, Manoj &amp; Biswas, Dibakar &amp; Ghosh, Sujoy &amp; Mukhopadhyay, Pradip &amp; MUKHOPADHYAY, SATINATH &amp; Chowdhury, Subhankar.\" data-hash=\"7902\" data-license=\"CC BY-NC SA 3.0\" data-source=\"https://www.researchgate.net/figure/CT-abdomen-showing-enlargement-distortion-of-architecture-and-loss-of-corticomedullary_fig2_258704358\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/bR7NmeKS9EIwvWBVGMtV1744023953.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>Acute infection of the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> involving the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> and collecting system is usually caused by <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> bacteria.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠It is a chronic <span class=\"customMeta\" data-dictid=\"9e1f97f6ad169277718805c2dd35c1\">granulomatous</span> response to <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> infection - that leads to the destruction of <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> and its replacement by lipid-laden foamy macrophages.</p>\n<p>⢠Destruction spreads from the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> pelvisâmedullaâ cortex. </p>\n<p>⢠Usually, staghorn <span class=\"customMeta\" data-dictid=\"7c0090409b16927771839521583331\">calculus</span> is present in the pelvis.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Severe <span class=\"customMeta\" data-dictid=\"f826a1a46e1692777193319fa1e5ed\">necrotizing</span> infection with gas accumulation in and around the kidney, primarily in <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> patients.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tZzJvCqC3GHNPm3iKIFP1748783094.mp3", "video": ""}, {"text": "A 12-year-old boy presents with a history of antenatal hydronephrosis detected on prenatal ultrasound. He now reports recurrent urinary tract infections and intermittent flank pain. Diuretic renography reveals delayed drainage of radiotracer. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Staghorn calculus", "correct": false}, {"label": "B", "text": "Vesicoureteric reflux (VUR)", "correct": false}, {"label": "C", "text": "Ureteropelvic junction (PUJ) obstruction", "correct": true}, {"label": "D", "text": "Urinary tract infection", "correct": false}], "correct_answer": "C. Ureteropelvic junction (PUJ) obstruction", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p><strong>PUJ Obstruction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p><strong>Vesicoureteric (VUR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p><strong>Staghorn Calculus</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:middle\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p>Narrowing at the <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> of the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"c25071fa3816927771955eeaf9d45e\">pelvis</span> and ureter.</p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p>Retrograde <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> flows from the <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> into the ureters.</p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p>Large, branched stone within the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"c25071fa3816927771955eeaf9d45e\">pelvis</span> and calyces</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:middle\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p>Commonly: <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">Congenital</span> <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> in ureteral muscle development.</p>\n<p>Less commonly: <span class=\"customMeta\" data-dictid=\"56af81fad316927771843d2b4b1e4f\">Compression</span> by an <span class=\"customMeta\" data-dictid=\"c98928d9d516927771805d7cdd0d06\">aberrant</span> or <span class=\"customMeta\" data-dictid=\"9088e1c7f616927771802e7f6d2541\">accessory</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> branch.</p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p>Malformation of the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> ureter, leading to an inadequate <span class=\"customMeta\" data-dictid=\"416dd1004a169277720177d9a6adc5\">valve</span> mechanism at the <span class=\"customMeta\" data-dictid=\"639b2545551692777201eeadb06d68\">vesicoureteric</span> junction</p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infection with urease-producing bacteria in the setting of <span class=\"customMeta\" data-dictid=\"b95c7f7b821692777181df660ee7ff\">alkaline</span> <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> and elevated <span class=\"customMeta\" data-dictid=\"edbc0adbb31692777181ed0ee792d4\">ammonia</span> levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:middle\">\n<p><strong>Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p><strong>Neonates:</strong> Antenatally detected hydronephrosis.</p>\n<p><strong>Older children/Adults:</strong> <span class=\"customMeta\" data-dictid=\"bd478e4ff816927771949528846af9\">Palpable</span> mass, <span class=\"customMeta\" data-dictid=\"8502a8f15e16927771909160b28bf2\">intermittent</span> flank/abdominal pain</p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p>Antenatal hydronephrosis, <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p>Symptoms of <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infection (e.g., pain, fever, frequent urination), <span class=\"customMeta\" data-dictid=\"316968b3e116927772021379938005\">flank</span> pain, haematuria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:middle\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p><strong>Ultrasound:</strong> Visualisation of hydronephrosis.</p>\n<p><strong>Diuretic renography:</strong> Delayed <span class=\"customMeta\" data-dictid=\"c5a32dfd6e1692777197db92b6aea1\">radiotracer</span> <span class=\"customMeta\" data-dictid=\"67d67b341916927772029cd0d951df\">washout</span> indicating obstruction</p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p><strong>Voiding <span class=\"customMeta\" data-dictid=\"7d3833cfbf1692777185c44c246cf4\">cystourethrogram</span> (VCUG):</strong> Demonstrates <span class=\"customMeta\" data-dictid=\"e38ca8e6931692777197ee6a68ac56\">retrograde</span> <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> flow from the <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> into the ureters.</p>\n<p><strong>DMSA scan:</strong> Can detect <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> scarring, a potential <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> of VUR.</p>\n</td>\n<td style=\"border-bottom:1px solid #1f1f1f; border-left:1px solid #1f1f1f; border-right:1px solid #1f1f1f; border-top:1px solid #1f1f1f; vertical-align:top\">\n<p><strong>CT scan:</strong> Depicts the large, branched stone; can assess for <span class=\"customMeta\" data-dictid=\"441df40d111692777189b0e31acb06\">hydronephrosis</span> and other complications. <strong>Plain radiograph:</strong> May also visualise the stone.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/j8urj1vdIVWGLat4ZfjE1748782768.mp3", "video": ""}, {"text": "A 66 y/o woman presents with pelvic pain and a palpable mass. Imaging studies show a pelvic mass with extensive calcification that has a characteristic \"popcorn\" appearance. Which of the following diagnoses is most consistent with these findings?", "options": [{"label": "A", "text": "Ureteric calculus", "correct": false}, {"label": "B", "text": "Vesical calculus", "correct": false}, {"label": "C", "text": "Uterine leiomyoma (fibroid)", "correct": true}, {"label": "D", "text": "Ovarian teratoma", "correct": false}], "correct_answer": "C. Uterine leiomyoma (fibroid)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/iJ3HHmSI27DH7D1KXXui1744023326.png", "https://image.prepladder.com/notes/omQXyW4cPX0JmxpPhDLq1744023347.png", "https://image.prepladder.com/notes/4FC2up46ANCbvh4T2jp31744023361.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Urinary Tract Calculi</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Type of Calculi</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Imaging Findings</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Ureteric Calculi</strong></p>\n<p><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>These are stones located in the ureters, which carry <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> from the kidneys to the bladder.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Size impacts the likelihood of <span class=\"customMeta\" data-dictid=\"f71e485d131692777199151d1076d2\">spontaneous</span> passage:</p>\n<p>⢠&lt;5 mm: High chance of passing naturally.</p>\n<p>⢠&gt;10 mm: Less likely to pass without intervention.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Identified via CT urography.</p>\n<p>⢠Can lead to <span class=\"customMeta\" data-dictid=\"441df40d111692777189b0e31acb06\">hydronephrosis</span> if it obstructs <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> flow. </p>\n<p>⢠White areas in the KUB X-ray indicate calcifications observed in the <span class=\"customMeta\" data-dictid=\"bed506dac916927771947fa5af9bd4\">paravertebral</span> location.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"KUB X-ray shows left upper ureteric calculus\" data-author=\"CC BY-NC Aboutaleb, Hamdy &amp; Omar, Mohamed &amp; Salem, Shady &amp; Elshazly, Mohamed.\" data-hash=\"7891\" data-license=\"CC BY-NC 3.0\" data-source=\"https://www.researchgate.net/figure/a-KUB-X-ray-shows-left-upper-ureteric-calculus-at-the-level-of-L4-b-Renal-ultrasound_fig1_312213712\" data-tags=\"April2025\" height=\"541\" src=\"https://image.prepladder.com/notes/iJ3HHmSI27DH7D1KXXui1744023326.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Vesical Calculi</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Stones that are found in the bladder.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Stones can either get <span class=\"customMeta\" data-dictid=\"ab375457da16927771891fcf9431da\">impacted</span> at the <span class=\"customMeta\" data-dictid=\"639b2545551692777201eeadb06d68\">vesicoureteric</span> <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> or be mobile in the bladder.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠CT <span class=\"customMeta\" data-dictid=\"76d8f9a76716927772019c9b8a5fb8\">urography</span> is valuable for <span class=\"customMeta\" data-dictid=\"55a682d72e16927771865bb4855ba3\">differentiation</span> between the two.</p>\n<p>⢠Prone positioning during <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> aids in differentiation. </p>\n<p>⢠Usually appears as a dense <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> in the <span class=\"customMeta\" data-dictid=\"1feb2a0a3016927771847db9449f75\">centre</span> of the pelvis.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"KUB shows Bladder stone with a sewing needle in its center.\" data-author=\"Palinrungi, Muhammad &amp; Kholis, Khoirul &amp; Syahrir, Syakri &amp; Bakri, Syarif &amp; Faruk, Muhammad.\" data-hash=\"7892\" data-license=\"CC BY-NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/KUB-shows-Bladder-stone-with-a-sewing-needle-in-its-center_fig1_338085824\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/omQXyW4cPX0JmxpPhDLq1744023347.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Popcorn Calcification</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>A radiological finding associated with severely calcified <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> fibroids (leiomyomas).</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Irregular, scattered calcifications resembling popped corn.</p>\n<p>⢠Common in <span class=\"customMeta\" data-dictid=\"c9ba8fa63616927771962d84263e40\">postmenopausal</span> women with degenerative changes in fibroids.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠On X-ray: Pelvic mass with severe calcification, characteristic popcorn pattern.</p>\n<p>⢠On CT: <span class=\"customMeta\" data-dictid=\"55436411c216927771846e318f45ce\">clearer</span> visualisation confirming calcified leiomyoma.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"The abdomino-pelvic CT showed a solid mass with multiple scattered calcifications\" data-author=\"Hwang, Jong &amp; Modi, Gayatri &amp; Oh, Min-Jeong &amp; Lee, Nak Woo &amp; Hur, Jun &amp; Lee, Kyu &amp; Lee, Jae\" data-hash=\"7893\" data-license=\"CC BY-NC ND 3.0\" data-source=\"https://www.researchgate.net/figure/A-X-ray-of-the-kidney-ureter-and-bladder-showed-a-calcified-mass-in-the-pelvic_fig1_47381615\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/4FC2up46ANCbvh4T2jp31744023361.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WaNsxCgkyAxF8ySyIz9R1748782250.mp3", "video": ""}, {"text": "A 60 y/o male presents with chronic back pain and a history of tuberculosis. A CT scan of the patient is given below. What is the most likely diagnosis based on these findings?", "options": [{"label": "A", "text": "Staghorn calculus", "correct": false}, {"label": "B", "text": "Medullary nephrocalcinosis", "correct": false}, {"label": "C", "text": "Putty kidney", "correct": true}, {"label": "D", "text": "Renal cell carcinoma", "correct": false}], "correct_answer": "C. Putty kidney", "question_images": ["https://image.prepladder.com/notes/rGIab4ms24Hu9BVUoNT61744022839.png"], "explanation_images": ["https://image.prepladder.com/notes/0SGmwKjFxS4PDzK7d2d41744022853.png", "https://image.prepladder.com/notes/zeERy8OHosPm21G1g5TU1744023041.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Staghorn Calculus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Putty Kidney</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Medullary Nephrocalcinosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Large, branching stone <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"c25071fa3816927771955eeaf9d45e\">pelvis</span> and calyces, resembling the shape of a staghorn.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tissue damage in the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> by <strong>TB</strong> leads to dystrophic calcification. Indicates end-stage <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> TB.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Calcium deposition </strong>within the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"53abb386551692777192c4d1f1f5ed\">medulla</span> (inner kidney).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Struvite stones</strong> formed from <strong>magnesium <span class=\"customMeta\" data-dictid=\"3719e878a4169277718109b2d3f67e\">ammonium</span> <span class=\"customMeta\" data-dictid=\"189b6fc834169277719580eb39bb4c\">phosphate</span> </strong>due to infection with <strong>urease-producing bacteria</strong> (e.g., Klebsiella, Proteus)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Renal tuberculosis</strong> leads to <span class=\"customMeta\" data-dictid=\"2334b7498b1692777188fa8b2eee36\">granuloma</span> formation causing necrosis, cavitation, <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> and <span class=\"customMeta\" data-dictid=\"329b77e4b11692777199930404f75c\">stricture</span> formation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolic disturbances</strong> (e.g., hyperparathyroidism, sarcoidosis, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> acidosis, <span class=\"customMeta\" data-dictid=\"0a36e18386169277719259641cf29b\">medullary</span> <span class=\"customMeta\" data-dictid=\"1f8d123d5a16927771996d6f75145f\">sponge</span> <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease) leading to <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> of the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> medulla</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Imaging Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Radio-opaque, visible on CT. They often <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> rapidly; fill the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"c25071fa3816927771955eeaf9d45e\">pelvis</span> and extend into calyces. <strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Appears as a <span class=\"customMeta\" data-dictid=\"61f84221371692777191a8e70c449c\">lobulated</span> mass of calcified tissue on CT scans, resembling <strong>\"putty\";</strong> indicating a <strong>non-functioning kidney.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Detected on plain radiographs, ultrasound, and CT. USG and CT are very specific and hence useful even in mild cases</p>\n<ul>\n<li>USG- <span class=\"customMeta\" data-dictid=\"165957ab9c16927771899a331e37b0\">hyperechoic</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> shadowing.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>CT- High-density <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> in the medulla<strong>(Option B ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9QFS2LLOXCG0TvwiTZZM1748782040.mp3", "video": ""}, {"text": "A 45 y/o male presents with sudden onset of severe right-sided flank pain and gross hematuria. He has a history of recurrent urinary tract infections. A non-contrast CT scan reveals a large, radio-opaque stone forming a staghorn shape in the renal pelvis. Which of the following is the most likely composition of the stone?", "options": [{"label": "A", "text": "Uric acid", "correct": false}, {"label": "B", "text": "Calcium oxalate", "correct": false}, {"label": "C", "text": "Struvite", "correct": true}, {"label": "D", "text": "Cystine", "correct": false}], "correct_answer": "C. Struvite", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/TGGpiY3ijyki8QqguGZA1744021175.png", "https://image.prepladder.com/notes/S2p0WSNzRTaSc5NSo6tZ1744021195.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT showing right staghorn calculi\" data-author=\"Mao, Zhiguo &amp; Xu, Jing &amp; Ye, Chaoyang &amp; Dongping, Chen &amp; Mei, Changlin\\\" data-hash=\"7880\" data-license=\"CC BY 2.0\" data-source=\"https://www.researchgate.net/figure/CT-images-of-a-complete-staghorn-calculus-in-the-right-kidney-in-an-ADPKD-female-Above_fig1_257133582\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/TGGpiY3ijyki8QqguGZA1744021175.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"X-ray showing staghorn calculi\" data-author=\"Nevit Dilmen\" data-hash=\"7881\" data-license=\"CC BY-SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Staghorn_Kidney_Stone_08779.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/S2p0WSNzRTaSc5NSo6tZ1744021195.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<p> </p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Type of Stone</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Composition</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Cause/Associated Condition</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Imaging Visibility</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Calcium-based stones</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Calcium <span class=\"customMeta\" data-dictid=\"28ddbfbaa51692777194aa6875fac4\">oxalate</span> or <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> phosphate</p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>High levels of <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> or <span class=\"customMeta\" data-dictid=\"28ddbfbaa51692777194aa6875fac4\">oxalate</span> in urine</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Radio-opaque (easily detected on imaging)</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Struvite stones</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Magnesium <span class=\"customMeta\" data-dictid=\"3719e878a4169277718109b2d3f67e\">ammonium</span> phosphate</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections (Klebsiella, Proteus, etc.)</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Radio-opaque (can <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> large staghorn calculi)</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Uric acid stones</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Uric acid <strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Acidic urine, gout, obesity, diabetes</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>5-8% are <span class=\"customMeta\" data-dictid=\"17825c11c616927771979bd9b0b285\">radiolucent</span> and can dissolve with <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> alkalinisation</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Cystine stones</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Cystine <strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Genetic disorder (cystinuria)</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Some radiolucent; detectable via unenhanced CT</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Drug-related stones</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Drug crystals (e.g., Indinavir)</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Certain medications (e.g., Indinavir)</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Radiolucent (harder to detect)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fCZnm6intgQIkg6eGCH01748781789.mp3", "video": ""}, {"text": "A 12-year-old girl is evaluated for recurrent urinary tract infections. Imaging studies reveal that she has a duplex collecting system, with the upper renal moiety's ureter inserting ectopically into the bladder. The lower renal moiety's ureter is positioned normally. According to Weigert-Meyer law, which of the following statements is true regarding her condition?", "options": [{"label": "A", "text": "The upper renal moiety's ureter typically drains into the bladder orthotopically.", "correct": false}, {"label": "B", "text": "The lower renal moiety's ureter is more likely to be associated with ureterocele.", "correct": false}, {"label": "C", "text": "Vesicoureteral reflux is more common with the lower renal moiety's ureter.", "correct": true}, {"label": "D", "text": "The ectopic ureter insertion of the upper moiety is often located lateral to the lower moiety's", "correct": false}], "correct_answer": "C. Vesicoureteral reflux is more common with the lower renal moiety's ureter.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/e8CXYM5nODIxf6IeIYxx1744020911.png", "https://image.prepladder.com/notes/WTN1n1hqU5B0ECoXqHAJ1744020966.png", "https://image.prepladder.com/notes/6LoDk0iy9VZ0gEjDat731744020991.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Cross fused Ectopic</strong></p>\n<p>⢠A rare <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> <span class=\"customMeta\" data-dictid=\"88900fc4c61692777191a66457050a\">malformation</span> where both kidneys are located on one side of the body (unilaterally), with the <span class=\"customMeta\" data-dictid=\"8cde7563da1692777201fca2b1f090\">ureter</span> of the <span class=\"customMeta\" data-dictid=\"6b4030e51a1692777185c6a9dc95b0\">crossed</span> <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> draining into the <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> on the opposite side (contralateral).</p>\n<p> </p>\n<p>⢠Presentations can range from incidental findings during <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> to <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> impairment, depending on the function and <span class=\"customMeta\" data-dictid=\"9e99effc421692777181b02606e021\">anatomy</span> of the affected kidneys.</p>\n<p> </p>\n<p>⢠Often identified through ultrasound, CT, or MRI, showing the kidneys positioned on the same side and their unique <span class=\"customMeta\" data-dictid=\"dd824a31e71692777186c7f8168998\">drainage</span> patterns.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"Cross fused Ectopic\" data-author=\"\" data-hash=\"7877\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"600\" src=\"https://image.prepladder.com/notes/e8CXYM5nODIxf6IeIYxx1744020911.png\" width=\"600\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Duplex collecting system</strong></p>\n<p>⢠A common <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> <span class=\"customMeta\" data-dictid=\"e7ed1a964716927771801ab913204a\">abnormality</span> is characterized by incomplete <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> of upper and lower pole moieties, leading to complete or incomplete <span class=\"customMeta\" data-dictid=\"a474651a3816927771869b71041ec1\">duplication</span> of the collecting system.</p>\n<p> </p>\n<p>⢠Duplex collecting systems may be associated with <span class=\"customMeta\" data-dictid=\"639b2545551692777201eeadb06d68\">vesicoureteric</span> reflux, obstruction, or ureterocele, despite being considered <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> variants.</p>\n<p> </p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> Characteristics</strong>: <strong>IVP</strong> can effectively image both collecting systems, but poorly <span class=\"customMeta\" data-dictid=\"bf1b7e7049169277720354c306d716\">functioning</span> systems may not <span class=\"customMeta\" data-dictid=\"350d30aa5316927771874442f8874c\">excrete</span> contrast, resulting in a<strong> \"drooping lily appearance\"</strong> of the <span class=\"customMeta\" data-dictid=\"bf1b7e7049169277720354c306d716\">functioning</span> lower pole moiety.</p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Duplex collecting system-drooping lily appearance\" data-author=\"Mohammad Taghi Niknejad\" data-hash=\"7878\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/drooping-lily-sign-ureter\" data-tags=\"April2025\" height=\"445\" src=\"https://image.prepladder.com/notes/WTN1n1hqU5B0ECoXqHAJ1744020966.png\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Weigert Meyer Law</strong></p>\n<p><strong>⢠Ureteral Drainage</strong>: The upper and lower <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> moieties each have separate ureters, each with its own <span class=\"customMeta\" data-dictid=\"1aca482e7e169277719443d10dbe5f\">orifice</span> in the bladder. </p>\n<p> </p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"0decefe0901692777186f7f3f89b2a\">Ectopic</span> Insertion</strong>: The upper <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"708d2a81e4169277719263f5f17227\">moiety</span> <span class=\"customMeta\" data-dictid=\"8cde7563da1692777201fca2b1f090\">ureter</span> typically inserts ectopically, <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> and <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> to the lower <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"708d2a81e4169277719263f5f17227\">moiety</span> ureter, often leading to a ureterocele. <strong>(Option D ruled out)</strong></p>\n<p> </p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"3517ba29e71692777194e61ada07a7\">Orthotopic</span> Insertion</strong>: The lower <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"708d2a81e4169277719263f5f17227\">moiety</span> <span class=\"customMeta\" data-dictid=\"8cde7563da1692777201fca2b1f090\">ureter</span> inserts <strong>orthotopically</strong>, <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> and superior to the upper moiety's ureter, with a risk of <span class=\"customMeta\" data-dictid=\"2b8a1464c91692777201a347e52ce5\">vesicoureteral</span> reflux. <strong>(Options A &amp; B ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"Duplication of collecting system with upper pole hydroureteronephrosis secondary to an intravesical obstructing ureterocele\" data-author=\"\" data-hash=\"7879\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"500\" src=\"https://image.prepladder.com/notes/6LoDk0iy9VZ0gEjDat731744020991.png\" width=\"500\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30 y/o presents with recurrent urinary tract infections and abdominal discomfort. An abdominal ultrasound is performed, revealing a fusion anomaly of the kidneys. Further imaging confirms the presence of a unique kidney shape, where both upper and lower poles are merged and located anterior to the aortic bifurcation. The CT Abdomen of the patient is given below. Which of the following is not the most likely diagnosis of the patient?", "options": [{"label": "A", "text": "Horseshoe Kidney", "correct": true}, {"label": "B", "text": "Pancake Kidney", "correct": false}, {"label": "C", "text": "Discoid Kidney", "correct": false}, {"label": "D", "text": "Fused Pelvic Kidney", "correct": false}], "correct_answer": "A. Horseshoe Kidney", "question_images": ["https://image.prepladder.com/notes/VwaQ9UnV9ZoTBNuKtxXM1744020597.png"], "explanation_images": ["https://image.prepladder.com/notes/670Nn3w2IgNOmcsH3Ldb1744020655.png", "https://image.prepladder.com/notes/h81qlk4JZ3W5iO7cXYVY1744020756.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Horseshoe Kidney</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pancake Kidney</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>⢠The most common <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> <span class=\"customMeta\" data-dictid=\"50a440f85816927771817d2fe50984\">anomaly</span> occurs in approximately 1 in 1000 births.</p>\n<p>⢠Results from <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> migration and midline <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> of both kidneys, usually at the lower poles (90%).</p>\n<p>⢠Kidneys point medially and are connected by a <span class=\"customMeta\" data-dictid=\"5d6dfa73b316927772028f3cd60f7f\">fibrous</span> band or <span class=\"customMeta\" data-dictid=\"bf1b7e7049169277720354c306d716\">functioning</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> known as <span class=\"customMeta\" data-dictid=\"290782db561692777190e9766fc8ae\">isthmus</span> which is not divided.</p>\n<p>⢠Normal <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> ascent is halted by the <strong>inferior mesenteric <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> origin</strong>. Usually present between 3rd to 5th <span class=\"customMeta\" data-dictid=\"683192f6b21692777191ae16feee76\">Lumbar</span> vertebrae.</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> Characteristics:</p>\n<p>⌠On <span class=\"customMeta\" data-dictid=\"7bb8f3fad9169277719504a3a31b12\">plain film</span> and IVU, a characteristic horseshoe <span class=\"customMeta\" data-dictid=\"1792af7b92169277718423182d599d\">configuration</span> is observed, though the <strong>isthmus </strong>may be poorly visualized.</p>\n<p>⌠Kidneys are typically low-lying and malrotated, with upper poles at the same height pointing superolateral, and lower poles pointing inferomedially.</p>\n<p>⢠Complications such as <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> ureteric <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> (PUJO), calculi, and Wilms' tumour.</p>\n<p>⢠Associated with <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> anomalies, <span class=\"customMeta\" data-dictid=\"1d84248e9f16927771850f8b75c26a\">cyclic</span> <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> syndrome (CVS), and syndromes like Turnerâs or Ellisâvan Creveld.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠A rare <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> <span class=\"customMeta\" data-dictid=\"50a440f85816927771817d2fe50984\">anomaly</span> where the upper and lower poles of the kidneys merge, resembling a pancake.</p>\n<p>⢠Typically located <strong>anterior to the aortic bifurcation.</strong></p>\n<p>⢠Usually has two separate ureters, but can occasionally have one.</p>\n<p>⢠Other Names: <strong>Discoid kidney</strong>, <strong>fused <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> kidney, cake kidney</strong>. <strong>(Option B, C &amp; D ruled out)</strong></p>\n<p>⢠Often <span class=\"customMeta\" data-dictid=\"d1a9a79f701692777182066af09044\">asymptomatic</span> but can lead to:</p>\n<p>⌠<span class=\"customMeta\" data-dictid=\"270dce3b38169277720179fd331e62\">Ureteropelvic</span> <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> obstruction</p>\n<p>⌠<span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">Recurrent</span> infections</p>\n<p>⌠<span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">Kidney</span> stones</p>\n<p>⌠Increased risk of malignancies</p>\n<p>⢠Identified through ultrasound, CT, MRI, IVU, and scintigraphy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT Abdomen showing Horseshoe kidney\" data-author=\"James Heilman, MD\" data-hash=\"7875\" data-license=\"CC BY-SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:HorseshoeKid2Mark.png\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/670Nn3w2IgNOmcsH3Ldb1744020655.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"> </p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CT Pancake Kidney\" data-author=\"Hamzeh M. Ghawanmeh, Mohmmad Al-Ghazo, Omar M. Halalsheh, Omar M. Al-Ghazo, Ahmad K. Alshammari, Anas I. Al-Karasneh, Radwan Al-Okour\" data-hash=\"7876\" data-license=\"CC BY NC ND\" data-source=\"https://www.sciencedirect.com/science/article/pii/S2214442016302054\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/h81qlk4JZ3W5iO7cXYVY1744020756.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bB745Tq5pOFhve9ecMI71747151013.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 33 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "What is the investigation shown in the image?", "options": [{"label": "A", "text": "Intravenous Pyelogram (IVP)", "correct": true}, {"label": "B", "text": "Retrograde Pyelogram", "correct": false}, {"label": "C", "text": "Computed Tomography (CT) Urography", "correct": false}, {"label": "D", "text": "Magnetic Resonance Urography", "correct": false}], "correct_answer": "A. Intravenous Pyelogram (IVP)", "question_images": ["https://image.prepladder.com/content/AIiZVt4yOlBlFrDp4G1K1741088084.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:466px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intravenous <span class=\"customMeta\" data-dictid=\"b28907b0441692777196ab31880644\">Pyelogram</span> (IVP)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>X-ray with IV contrast</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Urinary stones, hydronephrosis, <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> anomalies</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contrast <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> â <span class=\"customMeta\" data-dictid=\"b02f35d9471692777198bf98bee1f7\">serial</span> <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-rays</span> taken at intervals</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> function, <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> defects, delayed excretion</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 7-year-old male child presents with a history of recurrent urinary tract infections, poor urinary stream, and failure to thrive. On examination, his abdomen is distended, and there is a palpable bladder. His MCU is given below. What is the next best step in management?", "options": [{"label": "A", "text": "Cystoscopic resection", "correct": true}, {"label": "B", "text": "Urethral reconstruction", "correct": false}, {"label": "C", "text": "Intermittent catheterization", "correct": false}, {"label": "D", "text": "Bladder augmentation surgery", "correct": false}], "correct_answer": "A. Cystoscopic resection", "question_images": ["https://image.prepladder.com/content/pTPfw6B4noHSEh2iFClu1724749835.png"], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"8a8a7309fc169277718529cb457969\"&gt;Cystoscopic&lt;/span&g\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\">If <span class=\"customMeta\" data-dictid=\"2ead0fd0301692777185187bd72768\">creatinine</span> is normal </p>\n<p style=\"text-align: center;\">â</p>\n<p style=\"text-align: center;\">Endoscopic <span class=\"customMeta\" data-dictid=\"e06e32271216927772030141e67a00\">fulguration</span> of valve </p>\n</td>\n<td>\n<p style=\"text-align: center;\">If <span class=\"customMeta\" data-dictid=\"2ead0fd0301692777185187bd72768\">Creatinine</span> is raised (means there is no effective drainage) </p>\n<p style=\"text-align: center;\">â</p>\n<p style=\"text-align: center;\">Suprapubic <span class=\"customMeta\" data-dictid=\"f2dde065411692777185f9e915a087\">cystostomy</span> by blockson Technique.</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Based on the CT scan shown below, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Renal cyst", "correct": false}, {"label": "B", "text": "Renal cell carcinoma", "correct": false}, {"label": "C", "text": "Polycystic kidney disease", "correct": true}, {"label": "D", "text": "Renal angiomyolipoma", "correct": false}], "correct_answer": "C. Polycystic kidney disease", "question_images": ["https://image.prepladder.com/content/u4a1ghb49b9PJpipscFJ1724750349.png"], "explanation_images": ["https://image.prepladder.com/content/89KoMiU7H44T4VrJwvdZ1724750513.png", "https://image.prepladder.com/content/36OWT8ta66wwywbUvNeQ1724750535.png", "https://image.prepladder.com/content/HVe4iV0e6NfGUHrWv1Gz1724847005.png"], "explanation": "<p>Correct Option C â &lt;span class=\"customMeta\" data-dictid=\"ba336eb30516927771960f9d9bd85c\"&gt;Polycystic&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\"&gt;kidney&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old patient presents with recurrent urinary tract infections and left flank pain . CT scan of the abdomen was performed and the image is shown below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Horseshoe kidney", "correct": true}, {"label": "B", "text": "Polycystic kidney disease", "correct": false}, {"label": "C", "text": "Renal ectopia", "correct": false}, {"label": "D", "text": "Hydronephrosis", "correct": false}], "correct_answer": "A. Horseshoe kidney", "question_images": ["https://image.prepladder.com/content/KsvN28Z1nzlkwcVKPl4A1692689818.png"], "explanation_images": [], "explanation": "<p>Correct option A - Horseshoe k\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented with abdominal pain and sterile pyuria, and the x-ray showed the following features. What is the likely diagnosis?", "options": [{"label": "A", "text": "Putty kidney", "correct": true}, {"label": "B", "text": "Staghorn calculus", "correct": false}, {"label": "C", "text": "Nephrocalcinosis", "correct": false}, {"label": "D", "text": "Psoas calcification", "correct": false}], "correct_answer": "A. Putty kidney", "question_images": ["https://image.prepladder.com/content/od9sF9t3CToSaCrZqoRo1745317467.png"], "explanation_images": ["https://image.prepladder.com/content/aiXnBG0tEm0W305KBiPV1745317815.png", "https://image.prepladder.com/content/Aft7MzfZWjw6KSe9TLIk1745317770.png", "https://image.prepladder.com/notes/4EiUw3dGdj6COaXmUS3T1745915842.jpg", "https://image.prepladder.com/content/vqaMJEIjnXZXb5v8Ow0P1745317770.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:1000px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Staghorn Calculus</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Putty <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">Kidney</span> (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Medullary Nephrocalcinosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Large, branching stone <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"c25071fa3816927771955eeaf9d45e\">pelvis</span> and calyces, resembling the shape of a staghorn.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Tissue damage in the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> by TB leads to dystrophic calcification. Indicates end-stage <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> TB.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Calcium deposition within the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"53abb386551692777192c4d1f1f5ed\">medulla</span> (inner kidney).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Struvite stones formed from <span class=\"customMeta\" data-dictid=\"4d7ed0baae169277719199f6e9ab7b\">magnesium</span> <span class=\"customMeta\" data-dictid=\"3719e878a4169277718109b2d3f67e\">ammonium</span> <span class=\"customMeta\" data-dictid=\"189b6fc834169277719580eb39bb4c\">phosphate</span> due to infection with urease-producing bacteria (e.g., Klebsiella, Proteus)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Renal <span class=\"customMeta\" data-dictid=\"8d98ce2d3616927772013bfc3e0528\">tuberculosis</span> leads to <span class=\"customMeta\" data-dictid=\"2334b7498b1692777188fa8b2eee36\">granuloma</span> formation causing necrosis, cavitation, <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> and <span class=\"customMeta\" data-dictid=\"329b77e4b11692777199930404f75c\">stricture</span> formation.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Metabolic disturbances (e.g., hyperparathyroidism, sarcoidosis, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> acidosis, <span class=\"customMeta\" data-dictid=\"0a36e18386169277719259641cf29b\">medullary</span> <span class=\"customMeta\" data-dictid=\"1f8d123d5a16927771996d6f75145f\">sponge</span> <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease) leading to <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> of the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> medulla</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Imaging Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Radio-opaque, visible on CT. They often <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> rapidly; fill the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"c25071fa3816927771955eeaf9d45e\">pelvis</span> and extend into calyces. <strong>(Option B ruled out)</strong></p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Nephron\" data-hash=\"\" data-license=\"CC BY-SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Diffuse_proliferative_nephritis#/media/File:Diffuse_proliferative_lupus_nephritis_-_high_mag.jpg\" data-tags=\"\" height=\"300\" src=\"https://image.prepladder.com/content/aiXnBG0tEm0W305KBiPV1745317815.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Appears as a <span class=\"customMeta\" data-dictid=\"61f84221371692777191a8e70c449c\">lobulated</span> mass of calcified tissue on CT scans, resembling \"putty\"; indicating a non-functioning kidney.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Detected on plain radiographs, ultrasound, and CT. USG and CT are very specific and hence useful even in mild cases</p>\n<ul>\n<li>USG- <span class=\"customMeta\" data-dictid=\"165957ab9c16927771899a331e37b0\">hyperechoic</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> shadowing.</li>\n</ul>\n<p> </p>\n<ul>\n<li>CT- High-density <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> in the <span class=\"customMeta\" data-dictid=\"53abb386551692777192c4d1f1f5ed\">medulla</span> <strong>(Option C ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the case presented, can you identify the imaging technique employed and the specific diagnosis related to the kidneys?", "options": [{"label": "A", "text": "MRI of polycystic kidney disease", "correct": true}, {"label": "B", "text": "CT of polycystic kidney disease", "correct": false}, {"label": "C", "text": "MRI of Horseshoe kidney", "correct": false}, {"label": "D", "text": "CT of Horseshoe Kidney", "correct": false}], "correct_answer": "A. MRI of polycystic kidney disease", "question_images": ["https://image.prepladder.com/notes/5zsuEnADJpEpOk7Z9ytg1747911564.png"], "explanation_images": ["https://image.prepladder.com/notes/cKRD9QC4VlZkqHuoh8181747722144.png", "https://image.prepladder.com/content/oiVGD7iiKxpR3CRS5iwm1745921262.png", "https://image.prepladder.com/content/Z72aaMszFsKMpIH82V4S1745921262.png", "https://image.prepladder.com/content/5XZWEMh9L0zEvHQJsr3l1745921262.png", "https://image.prepladder.com/notes/Qe7YwPvJUuX3BfblqXVD1747722941.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ultrasound (USG)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Enlarged kidneys, multiple cysts</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>First-line screening in suspected PKD</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>CT Scan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Multiple cysts, hemorrhage, infection</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Detects complications like <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> or infection</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MRI</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>High-resolution <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> of cysts, no radiation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Preferred for assessing <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> function and disease progression</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Plain Radiograph</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Enlarged, multilobulated <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> outlines with <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> displacement.</li>\n<li>Multiple calcifications, sometimes with multiple ring appearance.</li>\n<li><strong>Intravenous urography</strong>: \"Swiss cheese nephrogram\" (due to multiple <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> cysts), \"Spiderleg pyelogram\" (stretched <span class=\"customMeta\" data-dictid=\"3cc82f8bfb1692777195602cfccef5\">pelvicalyceal</span> system).</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"Swiss Cheese pattern\" data-author=\"Moreira, Ana Sofia &amp; Castro, Miguel &amp; Grande, Pablo &amp; Gameiro, Ana &amp; Bahia Soares, Carla &amp; Costa, Yessica &amp; Silva, LuĂs &amp; Saraiva, JosĂŠ &amp; Dinis, MĂłnica.\" data-hash=\"13056\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/Swiss-Cheese-Appearance-Renal-ultrasound-showing-polycystic-kidneys-in-a-patient-with_fig3_314914201\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/cKRD9QC4VlZkqHuoh8181747722144.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ultrasound</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Simple cysts: Anechoic with thin walls, <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> enhancement, and <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> shadowing.</li>\n<li>Complicated cysts (haemorrhage/infection): Echogenic material within the cyst, possible wall calcification, absence of internal blood flow.</li>\n<li><strong>CEUS</strong>: Demonstrates enhancement</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Kristoffer Lindskov Hansen, Michael Bachmann Nielsen and Caroline Ewertsen\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Advanced_polycystic_kidney_disease_with_multiple_cysts.jpg\" data-tags=\"\" height=\"411\" src=\"https://image.prepladder.com/content/oiVGD7iiKxpR3CRS5iwm1745921262.png\" width=\"519\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>CT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Simple cysts: Rounded with near-water <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> and thin walls.</li>\n<li>Complications (haemorrhage/infection): Higher <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> and wall calcification.</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Yamada, Yasutoshi &amp; Enokida, Hideki &amp; Mitsuke, Akihiko &amp; Nishimura, Hiroaki &amp; Tatarano, Shuichi &amp; Nakagawa, Masayuki.\" data-hash=\"\" data-license=\"CC BY-NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/Preoperative-CT-Preoperative-CT-showing-large-polycystic-kidneys-occupying-the-pelvis_fig1_334567994\" data-tags=\"\" height=\"565\" src=\"https://image.prepladder.com/content/Z72aaMszFsKMpIH82V4S1745921262.png\" width=\"419\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<p><strong>CT showing ADPKD</strong></p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MRI</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>T2 MRI- The most sensitive <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> modality</li>\n<li>Both enlarged kidneys have multiple cysts</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Brisbane\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.ncbi.nlm.nih.gov/books/NBK373387/figure/fig4_1/\" data-tags=\"\" height=\"405\" src=\"https://image.prepladder.com/content/5XZWEMh9L0zEvHQJsr3l1745921262.png\" width=\"495\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<p><strong>MRI showing ADPKD</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "â What is the cause of the following appearance in IVP? ââ ââ", "options": [{"label": "A", "text": "Horseshoe kidney", "correct": false}, {"label": "B", "text": "Ureterocoele", "correct": true}, {"label": "C", "text": "Bladder tumor", "correct": false}, {"label": "D", "text": "Posterior urethral valve", "correct": false}], "correct_answer": "B. Ureterocoele", "question_images": ["https://image.prepladder.com/content/HTrlHMwsZKu4bz4ZCEys1746700807.png"], "explanation_images": ["https://image.prepladder.com/content/2wamZgTHhs1EWK7IPDg01746700875.png", "https://image.prepladder.com/content/a3zs614WB3xr9WsG4tBQ1746700879.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Ureterocele</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Maulik S Patel\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/ureterocele-bilateral#image-872455\" data-tags=\"\" height=\"261\" src=\"https://image.prepladder.com/content/2wamZgTHhs1EWK7IPDg01746700875.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<p><strong>USG showing <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> pouching at left and right ureteral orifices</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Maulik S Patel\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/ureterocele-bilateral#image-872455\" data-tags=\"\" height=\"381\" src=\"https://image.prepladder.com/content/a3zs614WB3xr9WsG4tBQ1746700879.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<p><strong>Bilateral âCobra headâ appearance of <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> ureters on X-ray Intravenous Urography</strong></p>\n</td>\n</tr>\n</tbody>\n\n<p><strong>References:</strong></p>\n<ul><li>âł Grainger and Allisonâs Diagnostic Radiology, 7th Edition, Page no: 678, 758</li><li>âł Textbook of Radiology and Imaging, David Sutton, 8th Edition, Volume 1, Page 2903</li><li>âł Maiden waist deformity | Radiology Reference Article | Radiopaedia.org</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old female patient presents to the emergency department with chills and rigors . She has acute pain in right flank region . The imaging is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Cholecystitis", "correct": false}, {"label": "B", "text": "Emphysematous pyelonephritis", "correct": true}, {"label": "C", "text": "Small bowel obstruction", "correct": false}, {"label": "D", "text": "Volvulus", "correct": false}], "correct_answer": "B. Emphysematous pyelonephritis", "question_images": ["https://image.prepladder.com/content/1H4qFDsGINPiWn2u3W4z1695740105.png"], "explanation_images": [], "explanation": "<p>Correct option B - Emphysematous pyeloneph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 18 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which view will best assess the maxillary sinus for potential fractures?", "options": [{"label": "A", "text": "Waters' view", "correct": true}, {"label": "B", "text": "Caldwell's view", "correct": false}, {"label": "C", "text": "Lateral view", "correct": false}, {"label": "D", "text": "Submentovertex view", "correct": false}], "correct_answer": "A. Waters' view", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/4watW4dLZn39meYMOxVx1744038523.png", "https://image.prepladder.com/notes/f8wVQRImAsQDi5Nffw2s1744038524.png", "https://image.prepladder.com/notes/1KvyaalZZSKh1d7oBdW61744038525.png", "https://image.prepladder.com/notes/5BIh8StKSuwrrI6XIPFk1744038526.png", "https://image.prepladder.com/notes/MCPmL6GiOknron2wV1Y01744038528.png", "https://image.prepladder.com/notes/KX10M6SiGKXcruXHB17O1744038529.png", "https://image.prepladder.com/notes/5fcGdSf2TiF1HFSkyQEI1744038531.png", "https://image.prepladder.com/notes/LKn3eH3kSmrbz5oSsXsZ1744038531.png", "https://image.prepladder.com/notes/kbyeA1Bj3NYx5vB1XxjZ1744038533.png", "https://image.prepladder.com/notes/uiFyxi9xhz1vTTy1ck7e1744038534.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Views</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Position</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-ray &amp; structure/disease used</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Watersâ View </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"NA\" data-hash=\"7961\" data-license=\"NA\" data-source=\"NA\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/4watW4dLZn39meYMOxVx1744038523.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Sen, Debraj &amp; Arora, Vijinder &amp; Adlakha, Saurabh &amp; Miglani, Harleen. \" data-hash=\"7962\" data-license=\"CC BY-NC-SA 3.0\" data-source=\"https://www.researchgate.net/figure/Radiograph-of-the-paranasal-sinuses-Waters-view-reveals-a-small-left-maxillary-antrum_fig2_311263600\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/f8wVQRImAsQDi5Nffw2s1744038524.png\"/>\n<ul>\n<li>Maxillary sinus</li>\n<li>Partially <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> sinus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Caldwellâs View</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"NA\" data-hash=\"7963\" data-license=\"NA\" data-source=\"NA\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/1KvyaalZZSKh1d7oBdW61744038525.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Morgan M, Walizai T, Fahrenhorst-Jones T, et al.\" data-hash=\"7964\" data-license=\"\" data-source=\"https://radiopaedia.org/articles/skull-caldwell-view-2\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/5BIh8StKSuwrrI6XIPFk1744038526.png\"/>\n<ul>\n<li>Frontal <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> (mainly)</li>\n<li>Ethmoid sinus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lateral View</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"NA\" data-hash=\"7965\" data-license=\"NA\" data-source=\"NA\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/MCPmL6GiOknron2wV1Y01744038528.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Morgan M, Walizai T, Er A, et al.\" data-hash=\"7966\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/skull-lateral-view-1\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/KX10M6SiGKXcruXHB17O1744038529.png\"/>\n<ul>\n<li>All sinuses visible</li>\n<li>Mastoid antrum/air cells</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Submentovertex View</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"NA\" data-hash=\"7967\" data-license=\"NA\" data-source=\"NA\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/5fcGdSf2TiF1HFSkyQEI1744038531.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Er A, Murphy A\" data-hash=\"7968\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/skull-submentovertex-view\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/LKn3eH3kSmrbz5oSsXsZ1744038531.png\"/>\n<ul>\n<li>Sphenoid <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> (from the base of skull)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Towneâs View (AP Axial)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"NA\" data-hash=\"7969\" data-license=\"NA\" data-source=\"NA\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/kbyeA1Bj3NYx5vB1XxjZ1744038533.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Matt A. Morgan\" data-hash=\"7970\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/towne-view-skull-ap-axial-view\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uiFyxi9xhz1vTTy1ck7e1744038534.png\"/>\n<p>Occipital bone fractures</p>\n<p>Posterior <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> <span class=\"customMeta\" data-dictid=\"30a1ba21881692777203de4e7b8537\">fossa</span> pathologies</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/c1yf8WiKty9vZXhKXxl31748150828.mp3", "video": ""}, {"text": "Which of the following sinuses does NOT drain through the osteomeatal unit?", "options": [{"label": "A", "text": "Maxillary sinus", "correct": false}, {"label": "B", "text": "Frontal sinus", "correct": false}, {"label": "C", "text": "Anterior ethmoid sinus", "correct": false}, {"label": "D", "text": "Posterior ethmoidal sinus", "correct": true}], "correct_answer": "D. Posterior ethmoidal sinus", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PUJFCJwp8ah3XgkFHZLa1748150976.mp3", "video": ""}, {"text": "Following CT image is kept as a spotter in your final year exam viva. What is the marked structure?", "options": [{"label": "A", "text": "Concha bullosa", "correct": false}, {"label": "B", "text": "Agger nasi cell", "correct": false}, {"label": "C", "text": "Pneumatized superior turbinate", "correct": false}, {"label": "D", "text": "Haller cell", "correct": true}], "correct_answer": "D. Haller cell", "question_images": ["https://image.prepladder.com/notes/MTvdXvw7iRLY0POedILm1744079142.png"], "explanation_images": ["https://image.prepladder.com/notes/chqxnyUlMPxrtT00Nt8w1744079142.png", "https://image.prepladder.com/notes/MTvdXvw7iRLY0POedILm1744079142.png", "https://image.prepladder.com/notes/pdswRXquds0HrnpLUR2B1744079143.png", "https://image.prepladder.com/notes/I0W9X7Id1aStWjRIDnt51744079143.png", "https://image.prepladder.com/notes/YeqYbYA3n7iqXPeCnrYS1744079144.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anterior Air cells:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Agger Nasi</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Anterior most air cell of <span class=\"customMeta\" data-dictid=\"77d6d0146716927771877b0c93c24f\">Ethmoid</span> sinus</li>\n<li><strong>Site:</strong> Within the <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">Lacrimal</span> bone in the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> side of the Orbit</li>\n<li>Relation: <span class=\"customMeta\" data-dictid=\"5a5df583551692777181550518132c\">Anterolateral</span> and <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> to the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> recess</li>\n</ul>\n<p><img alt=\"-\" data-author=\"Behboudi, Hassan &amp; Heirat, Abtin &amp; Behboudi, Hengameh &amp; Akbari, Maryam &amp; Ramezani, Naghi &amp; Shalchizadeh, Makan &amp; Hajian, Abbas &amp; Nemati, Shadman. \" data-hash=\"8011\" data-license=\"CC BY NC\" data-source=\"https://www.researchgate.net/figure/Coronal-image-with-arrowhead-showing-Agger-Nasi-air-cell-MS-maxillary-sinus-MT_fig1_351808634\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/chqxnyUlMPxrtT00Nt8w1744079142.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Haller cell</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Infraorbital <span class=\"customMeta\" data-dictid=\"77d6d0146716927771877b0c93c24f\">ethmoid</span> air cell</li>\n<li><strong>Site: </strong>Present between <span class=\"customMeta\" data-dictid=\"2622e18b3316927772034e514eb29d\">floor of orbit</span> and upper boundary of maxillary sinus</li>\n</ul>\n<p><img alt=\"-\" data-author=\"The Radswiki\" data-hash=\"8010\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/haller-cell-1?lang=gb\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/MTvdXvw7iRLY0POedILm1744079142.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bulla ethmoidalis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Most consistent and largest <span class=\"customMeta\" data-dictid=\"77d6d0146716927771877b0c93c24f\">ethmoid</span> air cell</li>\n<li>Located just <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> to the <span class=\"customMeta\" data-dictid=\"c946f91574169277718061a073cecb\">Agger</span> nasi</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posterior Air cells:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Onodi cell</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Also known as spheno-ethmoidal air cell</li>\n<li>Close proximity to <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> nerve and Internal <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> artery</li>\n<li>Better appreciable on CT- <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> view</li>\n</ul>\n<p><img alt=\"-\" data-author=\"Hellerhoff\" data-hash=\"8012\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Sphenoethmoidal_air_cell_-_Onodi_cell_-_CT_axial_001.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/pdswRXquds0HrnpLUR2B1744079143.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kGEt8FalSBixadLMArXm1748151409.mp3", "video": ""}, {"text": "A 28-year-old male presents with persistent nasal congestion, facial pain exacerbated by bending forward, thick yellow nasal discharge, and reduced olfaction for two weeks. CT imaging reveals abnormalities in the paranasal sinuses. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Viral rhinitis", "correct": false}, {"label": "B", "text": "Allergic rhinitis", "correct": false}, {"label": "C", "text": "Sinusitis", "correct": true}, {"label": "D", "text": "Nasal polyps", "correct": false}], "correct_answer": "C. Sinusitis", "question_images": ["https://image.prepladder.com/notes/gSr1on8L1XusEchkuCRJ1748191222.png"], "explanation_images": ["https://image.prepladder.com/notes/gSr1on8L1XusEchkuCRJ1748191222.png", "https://image.prepladder.com/notes/MsEmJIWCNisNpP5mAIPd1747215152.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:621px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute Sinusitis:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duration</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Symptoms lasting less than 4 weeks</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiology</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>CT: </strong>Frothy appearance due to presence of bubbles in fluid</li>\n</ul>\n<p><img alt=\"Sinusitis\" data-author=\"\" data-hash=\"13273\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/gSr1on8L1XusEchkuCRJ1748191222.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Most cases resolve spontaneously; <span class=\"customMeta\" data-dictid=\"509310d4411692777199f2ffdb7769\">symptomatic</span> relief with <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> decongestants, <span class=\"customMeta\" data-dictid=\"894da1dfe6169277719871d7210619\">saline</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> sprays, and analgesics.</li>\n<li>Antibiotics if bacterial infection is suspected (typically after 7-10 days of symptoms).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subacute sinusitis:</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symptoms lasting 4 to 12 weeks.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chronic sinusitis:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duration</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Symptoms lasting longer than 12 weeks.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiology</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CT: Bony <span class=\"customMeta\" data-dictid=\"dae4dea0581692777198fdef9fa684\">sclerosis</span> is seen and no air.\n\t\t\t\t<p style=\"text-align:center\"><img alt=\"Chronic sinusitis\" data-author=\"\" data-hash=\"12693\" data-license=\"\" data-source=\"\" data-tags=\"May2025\" height=\"270\" src=\"https://image.prepladder.com/notes/MsEmJIWCNisNpP5mAIPd1747215152.png\" width=\"270\"/></p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Intranasal corticosteroids to reduce inflammation.</li>\n<li>Saline irrigation.</li>\n<li>Antibiotics for bacterial exacerbations.</li>\n<li>Surgery (e.g., functional <span class=\"customMeta\" data-dictid=\"35ca8c2d5f16927771879351e8f97e\">endoscopic</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> surgery) in <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> cases to improve drainage.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The imaging below shows a double density sign in the paranasal sinuses. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute Bacterial sinusitis", "correct": false}, {"label": "B", "text": "Carcinoma- Maxillary sinus", "correct": false}, {"label": "C", "text": "Chronic Bacterial sinusitis", "correct": false}, {"label": "D", "text": "Allergic fungal sinusitis", "correct": true}], "correct_answer": "D. Allergic fungal sinusitis", "question_images": ["https://image.prepladder.com/notes/HOHRhK43ChgBvGAGEaK11744079145.png"], "explanation_images": ["https://image.prepladder.com/notes/BLPZky5YnnefkwaiuU4a1744079145.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:621px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiopathogenesis</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Allergic reaction to fungal organism (usually Aspergillus)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical presentation</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Age: 20-40 year females</li>\n<li><strong>B/L <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> polyposis</strong>: causing <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> obstruction</li>\n<li><strong>Characteristic peanut butter discharge:</strong> due to thick <span class=\"customMeta\" data-dictid=\"91bc3a9b3e16927771871bcff74db7\">eosinophilic</span> mucus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bent &amp; Kuhn criteria (used for Diagnosis)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Major criteria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Minor criteria</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Type-I Hypersensitivity</li>\n<li><strong>Nasal polyposis</strong></li>\n<li>Characteristic <strong>CT</strong> findings</li>\n<li><strong>Eosinophilic mucin</strong></li>\n<li>Positive fungal stain</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Asthma</li>\n<li>Unilateral disease</li>\n<li>Bone <span class=\"customMeta\" data-dictid=\"8f88b9c691169277718754ca072062\">erosion</span> (<strong>X-ray</strong>)</li>\n<li>Serum eosinophilia</li>\n<li><strong>Positive fungal culture</strong></li>\n<li>Charcot-leyden crystals</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiology</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT: Double density sign</strong></p>\n<p><img alt=\"-\" data-author=\" Amro Omar\" data-hash=\"8017\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/fungal-sinusitis-allergic-2#image-10740306\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/BLPZky5YnnefkwaiuU4a1744079145.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RUzO3iHs5vg8HDc05kTQ1748151788.mp3", "video": ""}, {"text": "A 20-year old male, following a fist fight where he got hit over his front face presented with pain and swelling over his nose. A leak from the nasal cavity was noted, watery in consistency. What is the initial investigation of choice to localize the site of leak?", "options": [{"label": "A", "text": "X-ray PNS", "correct": false}, {"label": "B", "text": "Beta-2 transferrin assay", "correct": false}, {"label": "C", "text": "HRCT", "correct": true}, {"label": "D", "text": "CT Angiography", "correct": false}], "correct_answer": "C. HRCT", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/kp067MPmGiPwajJgYMBj1744080578.png", "https://image.prepladder.com/notes/ImclyqOxB1oPXBM19vve1744080578.png", "https://image.prepladder.com/notes/C72Fekw23swfiLGKwlep1744080578.png", "https://image.prepladder.com/notes/EA3rSyxiqlUnHKOkEop81744080579.png"], "explanation": "<p><strong>Educational Objective:</strong></p>\n<ul><li>⤠Learning objective:</li><li>⤠Keroâs classification:</li><li>⤠Keroâs classification:</li><li>⤠Radiological classification used to determine the height of Olfactory fossa based on the height of lateral lamella of cribriform plate (evaluated in CT). Three categories:</li><li>⤠Radiological classification used to determine the height of Olfactory fossa based on the height of lateral lamella of cribriform plate (evaluated in CT).</li><li>⤠height of Olfactory fossa</li><li>⤠height of lateral lamella of cribriform plate</li><li>⤠Three categories:</li><li>⤠Three categories:</li><li>⤠Type-I 1-3 mm depth Type-II 4-7 mm depth (most common type) Type-III ⼠8 mm depth (â risk of CSF rhinorrhea)</li><li>⤠Type-I 1-3 mm depth</li><li>⤠Type-II 4-7 mm depth (most common type)</li><li>⤠4-7 mm depth (most common type)</li><li>⤠4-7 mm depth (most common type)</li><li>⤠Type-III ⼠8 mm depth (â risk of CSF rhinorrhea)</li><li>⤠⼠8 mm depth (â risk of CSF rhinorrhea)</li><li>⤠⼠8 mm depth (â risk of CSF rhinorrhea)</li></ul>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:356px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type-I</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1-3 mm depth</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type-II</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4-7 mm depth (most common type)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type-III</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>⼠8 mm depth (â risk of <span class=\"customMeta\" data-dictid=\"123c47549916927771854892334fb9\">CSF</span> rhinorrhea)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pXkwBxxCIkB16o2wnykK1748151973.mp3", "video": ""}, {"text": "Daniel, a 60 year old male presented with complaints of nasal obstruction and epistaxis. MRI Head showed the following. What is the likely diagnosis?", "options": [{"label": "A", "text": "Juvenile nasopharyngeal angiofibroma", "correct": false}, {"label": "B", "text": "Inverted papilloma", "correct": true}, {"label": "C", "text": "Esthesioneuroblastoma", "correct": false}, {"label": "D", "text": "Antrochoanal polyp", "correct": false}], "correct_answer": "B. Inverted papilloma", "question_images": ["https://image.prepladder.com/notes/aCT3vxXtOgX6rb80gcwa1748191592.jpeg"], "explanation_images": ["https://image.prepladder.com/notes/aCT3vxXtOgX6rb80gcwa1748191592.jpeg", "https://image.prepladder.com/notes/0mezFSeszjDD1um580e41744081114.png", "https://image.prepladder.com/notes/5QfdZGWDSS7TemsUeGmN1744081114.png", "https://image.prepladder.com/notes/3zwCETTeek7OANYq3tIx1744081115.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tumor of non-olfactory <span class=\"customMeta\" data-dictid=\"31ae8f4dc51692777193069d92be37\">mucosa</span> of nose and <span class=\"customMeta\" data-dictid=\"e23ca9914316927771948eba43a1e9\">paranasal</span> sinus.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Radiological IOC: MRI</strong> &gt; CT - shows <span class=\"customMeta\" data-dictid=\"19b43840a41692777184d27ec15616\">cerebriform</span> appearance</li>\n</ul>\n<p><strong>(Option B)</strong></p>\n<p><img alt=\"Inverted papilloma\" data-author=\"\" data-hash=\"13274\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/aCT3vxXtOgX6rb80gcwa1748191592.jpeg\"/></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Juvenile <span class=\"customMeta\" data-dictid=\"790f98dd571692777193fd47da1230\">nasopharyngeal</span> <span class=\"customMeta\" data-dictid=\"dc364f6a301692777181702ff7d53b\">angiofibroma</span> </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>IOC: Contrast enhanced CT scan (CECT)</strong> shows <strong>Holman miller sign</strong> (also known as) Antral sign - <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> bowing of <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> wall of maxillary sinus.</p>\n<p><img alt=\"-\" data-author=\"Ed Uthman from Houston\" data-hash=\"8038\" data-license=\"CC BY 2.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Inverted_Schneiderian_Papilloma_of_the_Nasal_Cavity_%288116183976%29.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/0mezFSeszjDD1um580e41744081114.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Esthesio- <span class=\"customMeta\" data-dictid=\"d6a30cc0d11692777193e25a043a08\">neuroblastoma</span> </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>IOC: MRI</strong> &gt;&gt; CT, <strong>âFigure of 8â appearance with waist over <span class=\"customMeta\" data-dictid=\"978aa37443169277718555206ddf9e\">cribriform</span> plate</strong> is seen in MRI.</p>\n<p><img alt=\"-\" data-author=\"Hani M. Al Salam \" data-hash=\"8039\" data-license=\"NA\" data-source=\"https://radiopaedia.org/images/545413?case_id=10774\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/5QfdZGWDSS7TemsUeGmN1744081114.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antrochoanal <span class=\"customMeta\" data-dictid=\"b5c135c2311692777196832953e406\">polyp</span> </strong><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>IOC: CECT</strong> - shows mass arising from <span class=\"customMeta\" data-dictid=\"99b9c745241692777192ef399e5eae\">maxillary sinus</span> extending into the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> <span class=\"customMeta\" data-dictid=\"ddba4206eb169277718335596e86da\">cavity</span> with widening of osteomeatal complex.</p>\n<br/>\n<img alt=\"-\" data-author=\"Frank Gaillard\" data-hash=\"8040\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/antrochoanal-polyp#image-24983\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/3zwCETTeek7OANYq3tIx1744081115.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old female presents with right ear bleeding and conductive hearing loss (Rinne negative, Weber lateralized to right following head trauma.CT findings as shown as below.What is the most likely diagnosis?", "options": [{"label": "A", "text": "Longitudinal fracture- Left temporal bone", "correct": false}, {"label": "B", "text": "Longitudinal fracture- Right temporal bone", "correct": true}, {"label": "C", "text": "Transverse fracture- Left temporal bone", "correct": false}, {"label": "D", "text": "Transverse fracture- Right temporal bone", "correct": false}], "correct_answer": "B. Longitudinal fracture- Right temporal bone", "question_images": ["https://image.prepladder.com/notes/1CsfUlCxmUkPs0l6RtOA1744081753.png"], "explanation_images": ["https://image.prepladder.com/notes/B5t8X1bZuLQsks4qqrlv1744081754.png", "https://image.prepladder.com/notes/xehScXKdwCpY5e2bMw5l1744081755.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Longitudinal fracture</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Transverse fracture</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fracture line across the/parallel to the long <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> of the <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> bone.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fracture line perpendicular to the long <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> of <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> bone.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Incidence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>More common</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less common</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mode of injury</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trauma to temporal/parietal region</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trauma to frontal/occipital region</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hemotympanum / TM rupture</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CSF Otorrhea</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Facial nerve damage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hearing loss</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conductive </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sensorineural </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Injury to labyrinth/ VIII nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rare</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiology (CT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"=\" data-author=\" Dalia Ibrahim\" data-hash=\"8044\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/longitudinal-temporal-bone-fracture-1\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/B5t8X1bZuLQsks4qqrlv1744081754.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Tabby A. Kennedy\" data-hash=\"8045\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/normal-temporal-bone-ct-with-annotated-images#image-53902184\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/xehScXKdwCpY5e2bMw5l1744081755.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/IVxXLdYqE5DT9Nq7lxPO1748152496.mp3", "video": ""}, {"text": "A 20-weeks primigravida complaints of severe headache, nausea and vomiting. MRI done showed the following. Which of the following combinations of diagnosis and investigation of choice is most appropriate?", "options": [{"label": "A", "text": "Tortuous internal carotid artery; CT angiogram", "correct": false}, {"label": "B", "text": "Sigmoid sinus thrombosis;NCCT", "correct": false}, {"label": "C", "text": "Tortuous internal carotid artery; CECT", "correct": false}, {"label": "D", "text": "Sigmoid sinus thrombosis; MR venogram", "correct": true}], "correct_answer": "D. Sigmoid sinus thrombosis; MR venogram", "question_images": ["https://image.prepladder.com/notes/bYBqU2e3sXUiTiOrtSEY1744081756.png"], "explanation_images": ["https://image.prepladder.com/notes/TwNA5w0qngN2Co5FSkcr1744081756.png", "https://image.prepladder.com/notes/JrffTVCo2tinwNP44OTq1744081756.png", "https://image.prepladder.com/notes/AIlIaAEN7AOyf1SucsyO1744081757.png", "https://image.prepladder.com/notes/qxLsw7sbizx0rYReZ5yy1744081758.png", "https://image.prepladder.com/notes/gQJGTJamnubeP5WTnPjG1744081759.png", "https://image.prepladder.com/notes/KAbDWK04A8EamOMj9zKS1744082395.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Females on OCPs, pregnancy</strong>.</p>\n<p>Hypercoagulable states: Protein-C,S <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> , Factor-V leiden mutation.</p>\n<p>Complication of CSOM/Mastoditis</p>\n<p>Trauma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe headache, nausea, vomiting</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CECT: </strong></p>\n<ul>\n<li>Non-opacification of <span class=\"customMeta\" data-dictid=\"9008060dc21692777198e329f5be75\">sigmoid</span> sinus</li>\n</ul>\n<img alt=\"=\" data-author=\"Mary-Louise Montague\" data-hash=\"8047\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/Sigmoid-Sinus-Thrombosis-Axial-CT-scan-with-contrast-showing-enhancement-of-the-right_fig9_236231619\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/TwNA5w0qngN2Co5FSkcr1744081756.png\"/>\n<ul>\n<li>Empty <span class=\"customMeta\" data-dictid=\"f7d3133242169277718518c059ad55\">delta</span> sign<strong>: (</strong>seen with contrast)</li>\n</ul>\n<p><img alt=\"=\" data-author='\"G Guenther A Arauz \"' data-hash=\"8048\" data-license=\"CC BY-NC-ND\" data-source=\"https://www.researchgate.net/figure/Delta-or-empty-triangle-sign-CT-scan-with-contrast-where-there-is-an-intraluminal_fig2_49688173\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/JrffTVCo2tinwNP44OTq1744081756.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>NCCT:</strong></p>\n<ul>\n<li><strong>Cord sign: </strong>Hyperdense vessel (attenuation) secondary to thrombosis</li>\n</ul>\n<img alt=\"-\" data-author=\"Barbara Simons, Geert Lycklama a Nijeholt and Robin Smithuis\" data-hash=\"8049\" data-license=\"NA\" data-source=\"https://radiologyassistant.nl/neuroradiology/sinus-thrombosis/cerebral-venous-thrombosis\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/AIlIaAEN7AOyf1SucsyO1744081757.png\"/>\n<ul>\n<li><strong>Delta sign: </strong>seen in CT without contrast (NCCT)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI (T2-weighted):</strong> Absent flow <span class=\"customMeta\" data-dictid=\"3ea4fc34801692777202b98af71861\">void</span> with associated <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">thrombosis</span> seen</p>\n<p><img alt=\"=\" data-author=\"Magdalena Targosz-Gajniak, Michal Arkuszewski, StanisĹaw OchudĹo, Grzegorz Opala\" data-hash=\"8050\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/T2-weighted-MRI-of-patient-with-transverse-and-sigmoid-sinus-thrombosis-1A_fig1_45271565\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/qxLsw7sbizx0rYReZ5yy1744081758.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CE-MRI:</strong> <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">Filling</span> <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> with <span class=\"customMeta\" data-dictid=\"56c933e0d41692777200b713c46640\">thrombus</span> seen (a-T1 ; b-T2 weighted image)</p>\n<p><img alt=\"-\" data-author=\"Joan C Vilanova\" data-hash=\"8051\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/Chronic-CVT-of-the-left-transverse-and-sigmoid-sinuses-in-a-62-year-old-woman-with_fig4_336316140\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/gQJGTJamnubeP5WTnPjG1744081759.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MR Venogram: Best investigation for localization</p>\n<p><img alt=\"-\" data-author='\"P. Khanal, Lekhjung Thapa, Mann Shrestha, Suman Bhattarai, Debaki Sapkota, Nooma Sharma, Upendra P Devkota\"' data-hash=\"8053\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/MRI-venography-showing-right-transverse-and-sigmoid-sinus-thrombosis-arrow_fig1_309594788\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/KAbDWK04A8EamOMj9zKS1744082395.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fsRKT2RQPvFgOR5ETGtU1747672328.mp3", "video": ""}, {"text": "Following sign was seen while performing a radiological investigation Identify the investigation and the corresponding diagnosis.", "options": [{"label": "A", "text": "MR Angiogram- Glomus jugulare", "correct": false}, {"label": "B", "text": "Digital subtraction Angiography-glomus jugulare", "correct": false}, {"label": "C", "text": "Digital subtraction Angiography- Carotid body tumor", "correct": true}, {"label": "D", "text": "MR Angiogram- Carotid body tumor", "correct": false}], "correct_answer": "C. Digital subtraction Angiography- Carotid body tumor", "question_images": ["https://image.prepladder.com/notes/QXg6qYYotlp9hhlESQdV1744082396.png"], "explanation_images": ["https://image.prepladder.com/notes/CKcfA3N1aCVYZ31Lbasy1744082396.png", "https://image.prepladder.com/notes/uvcafHLceJhvyaFS6Hxq1744082397.png", "https://image.prepladder.com/notes/RJYE0EdnkbwTSC1KVDzu1744082397.png", "https://image.prepladder.com/notes/7PfFtkhFiWgvLqyIjWaB1744082398.png", "https://image.prepladder.com/notes/NmgupgfXFXjGPpCZk0Pe1744082398.png", "https://image.prepladder.com/notes/N9UqYNRiYZjOup7730IQ1744082399.png", "https://image.prepladder.com/notes/1VpAfxESWLmzHI8Bl4HU1744082400.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>NCCT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\" Naim Qaqish\" data-hash=\"8057\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/carotid-body-tumor-17\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/RJYE0EdnkbwTSC1KVDzu1744082397.png\"/></p>\n<p style=\"text-align: center;\">Large well defined mass seen over <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> bifurcation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CECT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"Dewansh Mishra, Chandrasekharan Kesavadas, Bejoy Thomas, Vishnu Pujari, Amalan Ignatius\" data-hash=\"8058\" data-license=\"CC BY-NC-ND 4.0\" data-source=\"https://www.researchgate.net/figure/Left-carotid-body-tumor-A-well-defined-peripherally-enhancing-tumor-in-left-carotid_fig2_376554783\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/7PfFtkhFiWgvLqyIjWaB1744082398.png\"/></p>\n<p style=\"text-align: center;\">Well defined peripherally enhancing <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> at <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> bifurcation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI (T2-weighted)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"Paula Casserly, Patrick Kiely, John Fenton\" data-hash=\"8059\" data-license=\"NA\" data-source=\"https://www.researchgate.net/publication/23764867_Cervical_sympathetic_chain_schwannoma_masquerading_as_a_carotid_body_tumor_with_a_postoperative_complication_of_first-bite_syndrome\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/NmgupgfXFXjGPpCZk0Pe1744082398.png\"/></p>\n<p style=\"text-align: center;\">Mass splaying the <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> <span class=\"customMeta\" data-dictid=\"6c076ff67d1692777183dff2a71da1\">bifurcation</span> is seen</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MR Angiogram</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"Burgess Alfred, Calderon Moises, Marcos Jafif Cojab, Jorge Diego, Balanza Ricardo\" data-hash=\"8060\" data-license=\"CC BY-NC-ND 4.0\" data-source=\"https://www.researchgate.net/figure/Magnetic-resonance-angiography-showing-bilateral-carotid-body-tumors-at-the-level-of-the_fig1_321063963\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/N9UqYNRiYZjOup7730IQ1744082399.png\"/></p>\n<p style=\"text-align: center;\">Bilateral <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> body tumor seen</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Digital <span class=\"customMeta\" data-dictid=\"408be3f8d81692777199619278702d\">subtraction</span> Angiography (DSA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"-\" data-author=\"Frank Gaillard\" data-hash=\"8061\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/carotid-body-tumour-on-angiography\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/1VpAfxESWLmzHI8Bl4HU1744082400.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align: center;\"><strong>Lyre sign positive </strong><strong>(Option C)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9LOzFHAc1pKNTrWeBVwi1748152905.mp3", "video": ""}, {"text": "An elderly male presented with unilateral hearing loss associated with tinnitus came. Investigation done showed the following appearance. What is the investigation of choice for this condition?", "options": [{"label": "A", "text": "MRI without contrast", "correct": false}, {"label": "B", "text": "MRI with contrast", "correct": true}, {"label": "C", "text": "CT without contrast", "correct": false}, {"label": "D", "text": "Vertebral Angiography", "correct": false}], "correct_answer": "B. MRI with contrast", "question_images": ["https://image.prepladder.com/notes/wH0VPSQClVWhvh7dr03H1744082952.png"], "explanation_images": ["https://image.prepladder.com/notes/TvsGvNpD4pctkOSzIEn51744082952.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Investigation of choice/Gold standard: <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> with <span class=\"customMeta\" data-dictid=\"e3767003061692777187b931c6a08f\">Gadolinium</span> contrast</strong> - <strong>ice cream cone</strong> appearance seen on <strong>CP angle</strong>.</li>\n</ul>\n<p><img alt=\"-\" data-author=\"Antonio Rodrigues de Aguiar Neto\" data-hash=\"8068\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/vestibular-schwannoma-12\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/TvsGvNpD4pctkOSzIEn51744082952.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Other investigations:</strong>\n<ul>\n<li>CT (with/without contrast): done when <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> is not feasible</li>\n<li>Vertebral Angiography: though helps in localizing the tumor, it is not the investigation of choice.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/klTwZaAwVoHjUZhBM7At1748153791.mp3", "video": ""}, {"text": "Young female with lower jaw swelling, X-ray showed the following. What is the likely diagnosis", "options": [{"label": "A", "text": "Pindborg tumor", "correct": false}, {"label": "B", "text": "Adamantinoma", "correct": true}, {"label": "C", "text": "Sialolithiasis", "correct": false}, {"label": "D", "text": "Ranula", "correct": false}], "correct_answer": "B. Adamantinoma", "question_images": ["https://image.prepladder.com/notes/7BAXPokfHCKeqxDNBKIs1744082954.png"], "explanation_images": ["https://image.prepladder.com/notes/yfzc5i5p1llv7UfE5ndU1744082954.png", "https://image.prepladder.com/notes/N0xOAXtYkKdYcwwFYKxY1744082955.png", "https://image.prepladder.com/notes/ghhD0VaSM189KpwK8kyt1744082956.png", "https://image.prepladder.com/notes/DQ3eS0dFGDjRPbouGLoD1744082956.png", "https://image.prepladder.com/notes/Ven0OEe0tAJ1QieVAklC1744082957.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/0knOQA18dnlxaC2ieKa11748154098.mp3", "video": ""}, {"text": "Match the following X-rays with the corresponding pathologies 1) a) Coin in trachea 2) b) Coin in esophagus c) Button battery in esophagus d) Button battery in trachea", "options": [{"label": "A", "text": "1d 2a", "correct": false}, {"label": "B", "text": "1d 2b", "correct": false}, {"label": "C", "text": "1a 2b", "correct": false}, {"label": "D", "text": "1c 2b", "correct": true}], "correct_answer": "D. 1c 2b", "question_images": ["https://image.prepladder.com/notes/t4jhS7oy3xNVmotselwK1744083553.png", "https://image.prepladder.com/notes/K7Qy8U5lC4u0vDX7YsKR1744083555.png"], "explanation_images": ["https://image.prepladder.com/notes/3cn7jawpR54HzW8b4tps1744083556.png", "https://image.prepladder.com/notes/n3IkAk3XCcEUbxe4nley1744083558.png", "https://image.prepladder.com/notes/3wouQJw4RKwhgfTWYCxg1744083554.png", "https://image.prepladder.com/notes/t4jhS7oy3xNVmotselwK1744083553.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The MRI images below display a \"tram-track\" sign, characterized by enhancement surrounding the optic nerve. This radiological feature is most indicative of which condition?", "options": [{"label": "A", "text": "Optic neuritis", "correct": false}, {"label": "B", "text": "Optic nerve sheath meningioma", "correct": true}, {"label": "C", "text": "Optic nerve glioma", "correct": false}, {"label": "D", "text": "Orbital pseudotumor", "correct": false}], "correct_answer": "B. Optic nerve sheath meningioma", "question_images": ["https://image.prepladder.com/notes/yYzztPTNL7moj2y6TR2R1748193057.jpeg"], "explanation_images": ["https://image.prepladder.com/notes/GrYH7Na3EiJ6CEv7NIAP1744083559.png", "https://image.prepladder.com/notes/yYzztPTNL7moj2y6TR2R1748193057.jpeg"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic nerve <span class=\"customMeta\" data-dictid=\"ce27f87b7d16927771884484964b65\">glioma</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic <span class=\"customMeta\" data-dictid=\"44e9c0bbec169277719829907370ee\">sheath</span> meningioma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Fusiform <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve<br/>\n\t\t\t\t(option B ruled out)</li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"Ryan Thibodeau\" data-hash=\"8085\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/optic-nerve-meningioma-13?lang=gb\" data-tags=\"April2025\" height=\"451\" src=\"https://image.prepladder.com/notes/GrYH7Na3EiJ6CEv7NIAP1744083559.png\" width=\"353\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tram-track sign (thickening of meninges)</li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"Optic nerve sheath meningioma\" data-author=\"\" data-hash=\"13275\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"428\" src=\"https://image.prepladder.com/notes/yYzztPTNL7moj2y6TR2R1748193057.jpeg\" width=\"428\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Associated with <strong>NF-1</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Associated with <strong>NF-2</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year old female visited an Ophthalmology clinic with complaints of proptosis, difficulty in eye mobility and redness of eyes. Her TFT values were T3/T4-high, TSH-low. Which of the following structures shown in the right orbit is first to be affected first in her condition?", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2", "correct": false}, {"label": "C", "text": "3", "correct": true}, {"label": "D", "text": "4", "correct": false}], "correct_answer": "C. 3", "question_images": ["https://image.prepladder.com/notes/VmXQIIUz8Eo30uCbMJyR1744084464.png"], "explanation_images": ["https://image.prepladder.com/notes/LEBxQYpNj1gRnQZuzxBv1744084465.png", "https://image.prepladder.com/notes/5jwVy33X1XY2isqxmacL1744084465.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thyroid eye disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pseudotumor of orbit</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tolosa hunt syndrome</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tendon is spared</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tendon is involved</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Painful <span class=\"customMeta\" data-dictid=\"2cc1b4ff2216927771940a80e764a2\">ophthalmoplegia</span> with associated Sensory symptoms</strong> (Optic nerve/Trigeminal nerve +/- Cavernous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> involvement)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/OGQzuB76UghgLXDxd7wR1748157167.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 46-year-old male presented with chronic back pain and neck stiffness. An X-ray cervical spine is given below. What is the diagnosis?", "options": [{"label": "A", "text": "Ankylosing spondylitis", "correct": false}, {"label": "B", "text": "Diffuse idiopathic skeletal hyperostosis", "correct": true}, {"label": "C", "text": "Klippel feil syndrome", "correct": false}, {"label": "D", "text": "Sprengel deformity", "correct": false}], "correct_answer": "B. Diffuse idiopathic skeletal hyperostosis", "question_images": ["https://image.prepladder.com/notes/hd0tiC6IQMKQAYKclqGZ1746532626.png"], "explanation_images": ["https://image.prepladder.com/notes/iVxGl7xQWXXfHOhbQPHF1746620097.png", "https://image.prepladder.com/notes/07AvZfJcWkZsZ3WVL9dL1746620117.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unknown; associated with <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> conditions (e.g., diabetes)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Continuous flowing ossifications over vertebral bodies, preservation of disc spaces</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cervical and <span class=\"customMeta\" data-dictid=\"3c6021096816927772007954fcc158\">thoracic</span> spine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stiffness, chronic pain, <span class=\"customMeta\" data-dictid=\"2749f813cb16927771864616f3317f\">dysphagia</span> if <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">cervical</span> involvement</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Differential Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ankylosing spondylitis, degenerative disc disease</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symptomatic treatment with NSAIDs, physical therapy</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 39-year-old male patient presented with complaints of fever and cough. His chest radiograph shows an air bronchogram sign. The probable diagnosis is :", "options": [{"label": "A", "text": "Pleural effusion", "correct": false}, {"label": "B", "text": "Consolidation", "correct": true}, {"label": "C", "text": "Hilar lymphadenopathy", "correct": false}, {"label": "D", "text": "Bronchiectasis", "correct": false}], "correct_answer": "B. Consolidation", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/LZHx1mxm6Qojbzn71gl01689230899.png"], "explanation": "<p>Correct Option B.\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis based on the image of the scan given below?", "options": [{"label": "A", "text": "Pituitary apoplexy", "correct": false}, {"label": "B", "text": "Pituitary macroadenoma", "correct": false}, {"label": "C", "text": "Rathke cleft cyst", "correct": false}, {"label": "D", "text": "Craniopharyngioma", "correct": true}], "correct_answer": "D. Craniopharyngioma", "question_images": ["https://image.prepladder.com/content/eZJk4y8CnFQte5ruRiCh1697525313.png"], "explanation_images": ["https://image.prepladder.com/content/EWIUYWCu8ZeJgcqkq4dY1695368640.png", "https://image.prepladder.com/content/5ltXq03hD07n1ApPpHLp1695368645.png"], "explanation": "<p>Correct Option D: Craniopharyng\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a 50-year-old female patient who shows a progressive decline in visual clarity in her eye? A post-contrast CT scan of her head indicates the presence of thickening in a specific structure, in the image.", "options": [{"label": "A", "text": "Optic nerve sheath meningioma", "correct": true}, {"label": "B", "text": "Optic nerve glioma", "correct": false}, {"label": "C", "text": "Retinoblastoma", "correct": false}, {"label": "D", "text": "Rhabdomyosarcoma", "correct": false}], "correct_answer": "A. Optic nerve sheath meningioma", "question_images": ["https://image.prepladder.com/notes/zEnmrrCc8j0tix5oKTWe1747998067.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the labelled structure in the image?", "options": [{"label": "A", "text": "Midbrain", "correct": true}, {"label": "B", "text": "Pons", "correct": false}, {"label": "C", "text": "Medulla", "correct": false}, {"label": "D", "text": "Cerebellum", "correct": false}], "correct_answer": "A. Midbrain", "question_images": ["https://image.prepladder.com/notes/XJi35TQpZAMY1VV4JwZe1748002897.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient complains of neck stiffness and severe headache. The CT image shown below is suggestive of which of the following conditions?", "options": [{"label": "A", "text": "Meningitis", "correct": false}, {"label": "B", "text": "Subarachnoid hemorrhage", "correct": true}, {"label": "C", "text": "Intraparenchymal hemorrhage", "correct": false}, {"label": "D", "text": "Hemorrhagic stroke", "correct": false}], "correct_answer": "B. Subarachnoid hemorrhage", "question_images": ["https://image.prepladder.com/content/HaXxuMLZWvwz7Qi6OjK01745238098.png"], "explanation_images": ["https://image.prepladder.com/content/ksUfoWxzqsI5v172mnGr1745238257.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Presence of blood in the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space, typically from a ruptured cerebral <span class=\"customMeta\" data-dictid=\"f2c92eaffe16927771819978aa5666\">aneurysm</span> or trauma.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sudden, severe headache (often described as a \"thunderclap headache\")</li>\n<li>Worst headache ever experienced by the patient.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Traumatic: </strong>Head injuries causing <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> in the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space.</li>\n<li><strong>Non-Traumatic: </strong>Most commonly due to <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> of a cerebral aneurysm.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Initial Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Contrast CT (NCCT):</strong> First-line <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> for suspected SAH, effective in the <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> setting.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Findings (NCCT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Appearance of Blood:</strong> Hyperdense (white) compared to surrounding <span class=\"customMeta\" data-dictid=\"99a9bf133e1692777184ec4b1011fe\">cerebrospinal</span> fluid (CSF).</p>\n<p>Common Sites for Blood Accumulation:</p>\n<ul>\n<li>Interhemispheric Fissure</li>\n<li>Sylvian Fissure</li>\n<li>Suprasellar Cistern</li>\n<li>Perimesencephalic Cistern</li>\n</ul>\n<p>Distinctive Shape: Blood may take on a pentagon or star shape, <span class=\"customMeta\" data-dictid=\"047f8930dd1692777197fed61e213c\">referred</span> to as the \"<strong>Star of Death.\"</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"James Heilman, MD\" data-hash=\"\" data-license=\"CC BY-SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Subarachnoid_hemorrhage\" data-tags=\"\" height=\"576\" src=\"https://image.prepladder.com/content/ksUfoWxzqsI5v172mnGr1745238257.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Additional Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT Angiography:</strong> Visualizes potential aneurysms or <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> malformations; useful for <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> suspicion.</p>\n<p><strong>Digital Subtraction Angiography (DSA):</strong> Gold standard for diagnosing cerebral aneurysms; provides detailed <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> images and <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> options (e.g., <span class=\"customMeta\" data-dictid=\"0dc32a9edf1692777187a82b199252\">endovascular</span> coiling).</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A cystic lesion in the suprasellar region with calcification is seen on the MRI. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Craniopharyngioma", "correct": true}, {"label": "B", "text": "Pituitary adenoma", "correct": false}, {"label": "C", "text": "Meningioma", "correct": false}, {"label": "D", "text": "Oligodendroglioma", "correct": false}], "correct_answer": "A. Craniopharyngioma", "question_images": ["https://image.prepladder.com/notes/E3lPB1ytUGqWCKj9QDIE1746433599.png"], "explanation_images": ["https://image.prepladder.com/content/tyAKtMbLXv8sgCDdOWld1745237589.png", "https://image.prepladder.com/content/66Qy2fEIWH3qeVrh3uPC1745237604.png", "https://image.prepladder.com/content/R3F8nVU4B51VaIkNcxbM1745237652.png", "https://image.prepladder.com/content/i9Wlz9dPafA2tGbam3Jm1745237662.png", "https://image.prepladder.com/content/WNFZfwIe2q1Gxt5lTcgG1745237672.png", "https://image.prepladder.com/content/SPYQPeJ7PpeDraHRlwMR1745237682.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Craniopharyngioma </strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"1. Eduardo, Denislene &amp; Franco, Suyane &amp; Castro, JosĂŠ. 2. Gaillard F, Yap J, Elfeky M\" data-hash=\"\" data-license=\"1. CC BY 4.0 2. NA\" data-source=\"1. https://www.researchgate.net/figure/Adamantinomatous-craniopharyngioma-Contrast-enhanced-MRI-scan-showing-a-cystic-component_fig5_322507541 2. https://radiopaedia.org/articles/papillary-craniopharyngioma\" data-tags=\"\" height=\"530\" src=\"https://image.prepladder.com/content/tyAKtMbLXv8sgCDdOWld1745237589.png\" width=\"940\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Craniopharyngiomas are <strong>suprasellar tumors</strong> that develop from remnants of the <span class=\"customMeta\" data-dictid=\"033ae9cbaf16927771858933478ef9\">craniopharyngeal</span> <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> or <strong>Rathkeâs pouch</strong>.</li>\n<li>It <span class=\"customMeta\" data-dictid=\"c6486470671692777184e25019e1f0\">compress</span> <strong>Optic chaism </strong>leads to <strong>bitemporal hemianopia.</strong></li>\n<li><strong>Adamantinomatous subtype</strong>\n<ul>\n<li>It<strong> </strong>is more common</li>\n<li>Seen in<strong> children</strong></li>\n<li>Typically appear as <strong>large, lobulated, multiloculated <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> lesions</strong> with a small enhancing solid component and<strong> calcifications</strong>.</li>\n</ul>\n</li>\n<li><strong>Papillary subtype </strong>\n<ul>\n<li>Seen in Adults</li>\n<li>Primarily solid lesion</li>\n<li>Rarely exhibit calcifications</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Pituitary <span class=\"customMeta\" data-dictid=\"c3c9726266169277718021f4f0fa16\">Adenoma</span> </strong><strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Quinn, Mark &amp; Bashari, Waiel &amp; Smith, Diarmuid &amp; Gurnell, Mark &amp; Agha, Amar. \" data-hash=\"\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/MRI-Pituitary-MRI-Pituitary-showing-enlargement-of-the-left-side-of-the-pituitary_fig2_343923314\" data-tags=\"\" height=\"846\" src=\"https://image.prepladder.com/content/66Qy2fEIWH3qeVrh3uPC1745237604.png\" width=\"940\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Elthokapy M\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/pituitary-macroadenoma-64\" data-tags=\"\" height=\"665\" src=\"https://image.prepladder.com/content/R3F8nVU4B51VaIkNcxbM1745237652.png\" width=\"940\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Pituitary Microadenomas </strong></p>\n<ul>\n<li><strong>Less than 10 mm</strong> in size.</li>\n<li>Microadenomas appear <span class=\"customMeta\" data-dictid=\"ad45f1e11716927771901f3d9b18eb\">isointense</span> to the <span class=\"customMeta\" data-dictid=\"b775f0c475169277719593c573f6ff\">pituitary</span> on T1-weighted images and slightly <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> on T2-weighted images.</li>\n<li>In <strong>dynamic contrast-enhanced MRI</strong>, they <strong>enhance slowly compared</strong> to the surrounding <span class=\"customMeta\" data-dictid=\"b775f0c475169277719593c573f6ff\">pituitary</span> gland.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Pituitary Macroadenomas</strong></p>\n<ul>\n<li><strong>Larger than 10 mm</strong> in size.</li>\n<li>Most of the macroadenomas are<strong> nonfunctioning.</strong></li>\n<li>They may cause <span class=\"customMeta\" data-dictid=\"d8216cf7571692777187baa94b8612\">endocrine</span> disturbances or <span class=\"customMeta\" data-dictid=\"c6486470671692777184e25019e1f0\">compress</span> the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> chiasm, leading to <span class=\"customMeta\" data-dictid=\"3b17da47ce16927771831d5dde3af3\">bitemporal</span> hemianopia.</li>\n<li>Typically appear as <strong>sellar-suprasellar masses</strong> with a <strong>âsnowmanâ </strong>or <strong>âfigure of eightâ </strong>appearance due to a <strong>waist at the <span class=\"customMeta\" data-dictid=\"1c1845d29e16927771860d473fc57c\">diaphragma</span> sellae</strong>.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"02db2e09e91692777198e14771cb3b\">sella</span> is usually enlarged.</li>\n<li>These tumors can invade the <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">cavernous</span> sinuses.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Meningioma </strong><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Gaillard F, Bell D, Thibodeau R, et al\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/dural-tail-sign-1\" data-tags=\"\" height=\"949\" src=\"https://image.prepladder.com/content/i9Wlz9dPafA2tGbam3Jm1745237662.png\" width=\"940\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Gaillard F, Baba Y, Lorente E\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/csf-cleft-sign-1\" data-tags=\"\" height=\"1035\" src=\"https://image.prepladder.com/content/WNFZfwIe2q1Gxt5lTcgG1745237672.png\" width=\"940\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Meningiomas arise from <strong>arachnoidal cap cells</strong> in the brain and <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> cord coverings.</li>\n<li>They are the <strong>most common <span class=\"customMeta\" data-dictid=\"1bbae82f1f16927771824f797639fa\">benign</span> <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> tumors</strong>.</li>\n<li>Most common in females</li>\n<li>Mostly <span class=\"customMeta\" data-dictid=\"a325d0c14e16927771992fe8a96758\">sporadic</span> but can be <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to NF-2 or prior <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> irradiation.</li>\n<li>Meningiomas are <span class=\"customMeta\" data-dictid=\"bec08dbe0c16927771864d7774d7b0\">dural</span> based<strong> extra-axial </strong>masses that appear <span class=\"customMeta\" data-dictid=\"ad45f1e11716927771901f3d9b18eb\">isointense</span> to <span class=\"customMeta\" data-dictid=\"4baa7caf471692777188e7f07ce90e\">gray matter</span> on both T1 and T2-weighted images.</li>\n<li>They demonstrate intense<strong> <span class=\"customMeta\" data-dictid=\"d9ec45007b1692777189e3b26e44ca\">homogeneous</span> <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> </strong>on post-contrast imaging, accompanied by a <strong>dural tail sign</strong>.</li>\n<li><strong>Characteristic <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> features:</strong>\n<ul>\n<li><strong>CSF <span class=\"customMeta\" data-dictid=\"7aa38569251692777184021705e8de\">cleft</span> sign </strong>(thin layer of CSF around the mass)</li>\n<li>Cortical buckling</li>\n<li>Widening of the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space with visible pial arteries/veins,</li>\n<li><strong>Hyperostosis</strong> or <span class=\"customMeta\" data-dictid=\"8f88b9c691169277718754ca072062\">erosion</span> of the calvarium.</li>\n<li><strong>Mother in law sign</strong><strong> </strong>(early <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> during the arterial phase and remain opacified long after the <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> phase has passed)</li>\n<li>Calcification</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Oligodendroglioma </strong><strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"radhiana hassan\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiologycases.my/2020/04/15/oligodendroglioma/\" data-tags=\"\" height=\"699\" src=\"https://image.prepladder.com/content/SPYQPeJ7PpeDraHRlwMR1745237682.png\" width=\"940\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>Oligodendrogliomas</strong> are <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> infiltrating glial tumors originating from oligodendrocytes and are characterized by <strong>IDH mutations</strong> and<strong> 1p/19q codeletion</strong>.</li>\n<li>These tumors can be either <strong>WHO <span class=\"customMeta\" data-dictid=\"d4ae50897e16927771884b5c46ba7d\">grade</span> 2</strong> (well-differentiated oligodendrogliomas) or <strong>WHO <span class=\"customMeta\" data-dictid=\"d4ae50897e16927771884b5c46ba7d\">grade</span> 3</strong> (anaplastic oligodendrogliomas).</li>\n<li>Typically occurs in the <strong>frontal lobe</strong>.</li>\n<li>They are slow-growing, non-encapsulated, and tend to <span class=\"customMeta\" data-dictid=\"8fd5e2898d16927771900855b98180\">infiltrate</span> the overlying<strong> cortex</strong>.</li>\n<li><strong>CT</strong>: Oligodendrogliomas are <span class=\"customMeta\" data-dictid=\"7f06e594de1692777190bfb4be030b\">isodense</span> to <span class=\"customMeta\" data-dictid=\"11309a56bc1692777189e89a8d3041\">hypodense</span> with<strong> calcification</strong></li>\n<li><strong>MRI</strong>: Tumors are <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> on T1 and <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> on T2. They generally do not enhance with contrast</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 22-year-old male arrived at the emergency room after being involved in a car accident. During the examination, his Glasgow Coma Scale (GCS) score was E2M2V3, indicating a level of consciousness. No fractures, hydrocephalus, or increased pressure within the skull were detected. A non-contrast CT scan was conducted and showed no abnormalities. The probable diagnosis is-", "options": [{"label": "A", "text": "Diffuse axonal injury", "correct": true}, {"label": "B", "text": "Post-concussion syndrome", "correct": false}, {"label": "C", "text": "Extradural hemorrhage", "correct": false}, {"label": "D", "text": "Herniation of brain", "correct": false}], "correct_answer": "A. Diffuse axonal injury", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/57Gm9RGLdJ435qSc0voI1746534262.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>High-speed trauma, rotational forces, falls</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Shearing of axons due to rapid acceleration/deceleration</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Unconsciousness, low GCS, no <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> deficits</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Imaging Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Normal CT initially; MRI shows microhemorrhages (FLAIR, GRE sequences)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Supportive care, ICU monitoring, neuroprotection</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An elderly man presents with a 7-month history of progressive dysphagia and bad breath. An image is provided. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Achalasia", "correct": false}, {"label": "B", "text": "Carcinoma esophagus", "correct": false}, {"label": "C", "text": "Zenker diverticulum", "correct": true}, {"label": "D", "text": "Diffuse esophageal spasm", "correct": false}], "correct_answer": "C. Zenker diverticulum", "question_images": ["https://image.prepladder.com/content/dre4Ps0UvD3PNPztJSZJ1741855376.png"], "explanation_images": ["https://image.prepladder.com/content/TOWDRIR07UF3g1eRvBys1741855386.png", "https://image.prepladder.com/content/aDzu2Z8lU7ouhF0oC4zs1741772877.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 22-year-old male was brought to the emergency room after being involved in a car accident. During the examination, his Glasgow Coma Scale (GCS) score was E2M2V3. There were no fractures, hydrocephalus, or increased pressure within the skull. A non-contrast CT scan was conducted and revealed no abnormalities. The suspected diagnosis is", "options": [{"label": "A", "text": "Diffuse axonal injury", "correct": true}, {"label": "B", "text": "Post-concussion syndrome", "correct": false}, {"label": "C", "text": "Extradural haemorrhage", "correct": false}, {"label": "D", "text": "Herniation of brain", "correct": false}], "correct_answer": "A. Diffuse axonal injury", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following MRI imaging techniques is shown in the image below?", "options": [{"label": "A", "text": "T1 MRI", "correct": false}, {"label": "B", "text": "T2 MRI", "correct": true}, {"label": "C", "text": "STIR", "correct": false}, {"label": "D", "text": "FLAIR", "correct": false}], "correct_answer": "B. T2 MRI", "question_images": ["https://image.prepladder.com/content/pj5zcRlSg8l3GzamfD771747909997.png"], "explanation_images": ["https://image.prepladder.com/content/0fIC1ybK33yDxdIi86Bk1746092579.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>MRI Sequence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>CSF Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Fat Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Use Cases</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>T1-weighted</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dark</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bright</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anatomy, fat-containing lesions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>T2-weighted</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bright</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Darker</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Edema, inflammation, tumors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>FLAIR</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dark</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dark</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>White matter lesions, <span class=\"customMeta\" data-dictid=\"a71c8cfa8216927771955861218d80\">periventricular</span> pathology</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>STIR</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dark</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dark</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Suppresses fat signal, good for <span class=\"customMeta\" data-dictid=\"09b955b4f91692777193bd4080e7fc\">musculoskeletal</span> imaging</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the structure marked in the image given below.", "options": [{"label": "A", "text": "External capsule", "correct": false}, {"label": "B", "text": "Internal Capsule", "correct": true}, {"label": "C", "text": "Caudate nucleu", "correct": false}, {"label": "D", "text": "Putamen", "correct": false}], "correct_answer": "B. Internal Capsule", "question_images": ["https://image.prepladder.com/notes/QrKSUsy7uRfTshEhaoil1747383478.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 2-month-old infant is brought to the OPD with a parietal swelling present since birth. The X-ray image is given below. What could be the probable diagnosis?", "options": [{"label": "A", "text": "Subgaleal hematoma", "correct": false}, {"label": "B", "text": "Cephalohematoma", "correct": true}, {"label": "C", "text": "Caput succedaneum", "correct": false}, {"label": "D", "text": "Enecephalocele", "correct": false}], "correct_answer": "B. Cephalohematoma", "question_images": ["https://image.prepladder.com/notes/IrL95MdbB9d1n2UFCjbh1745913268.png"], "explanation_images": ["https://image.prepladder.com/content/lqIT8CVniFBcfpaA8jn01745317400.png", "https://image.prepladder.com/notes/2CatLN1TXhFMsHk2HvGS1745913270.png", "https://image.prepladder.com/notes/WwwhT42Y2w7dmD8OhAAk1745913271.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:629px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Characteristic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Caput Succedaneum</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Cephalohematoma</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Incidence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Common</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Less common</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Subcutaneous plane</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Over <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> bones, between the skull and periosteum.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Time of Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Maximum size and firmness at birth.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Develops during the 1st few hours of life. Increasing size for 12-24 hours and then stable.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Time Course</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Softens progressively from birth.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Takes 3-6 weeks to resolve, but may resolve within 2-3 days.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Characteristic Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Diffuse Circular boggy area of oedema with indistinct borders.</li>\n<li>Often with overlying ecchymosis</li>\n<li>Crosses <span class=\"customMeta\" data-dictid=\"90dcd6e02316927771990a5c253ff7\">suture</span> line</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Well-circumscribed fluid-filled mass.</li>\n<li>Does not cross the <span class=\"customMeta\" data-dictid=\"90dcd6e02316927771990a5c253ff7\">suture</span> line</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Association</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>None</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Linear skull <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> (5-25%); hyperbilirubinemia</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"AMH Sheikh\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Scalp_hematomas.jpg\" data-tags=\"\" height=\"288\" src=\"https://image.prepladder.com/content/lqIT8CVniFBcfpaA8jn01745317400.png\" width=\"865\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented with a head injury after a hammer fell on the skull. CT is shown below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Concussion", "correct": false}, {"label": "B", "text": "Epidural hematoma", "correct": false}, {"label": "C", "text": "Depressed skull fracture", "correct": true}, {"label": "D", "text": "Subarachnoid hemorrhage", "correct": false}], "correct_answer": "C. Depressed skull fracture", "question_images": ["https://image.prepladder.com/content/hDwXksAKSEZUl4k0INHq1695741226.png"], "explanation_images": ["https://image.prepladder.com/content/hDwXksAKSEZUl4k0INHq1695741226.png"], "explanation": "<p>Correct option C - Depressed skull fractu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the radiological image of the condition given below.", "options": [{"label": "A", "text": "Paget's disease", "correct": true}, {"label": "B", "text": "Multiple myeloma", "correct": false}, {"label": "C", "text": "Hyperparathyroidism", "correct": false}, {"label": "D", "text": "Sickle cell anemia", "correct": false}], "correct_answer": "A. Paget's disease", "question_images": ["https://image.prepladder.com/content/idlWVOcOTTl9RgoBNbtz1747225581.png"], "explanation_images": ["https://image.prepladder.com/content/hIFIpkawgXWjpYlGNvGl1747381369.png", "https://image.prepladder.com/content/qEcu9oUsJvzo3LAsq04H1747381392.png", "https://image.prepladder.com/content/u6kMEYRkpGzspT1zmdzu1747381509.png", "https://image.prepladder.com/content/GSKiO5X3jBpfmqhFONH51747381583.png", "https://image.prepladder.com/content/KgEXPJkt40OId0Zs6jqU1747381593.png", "https://image.prepladder.com/content/t5S0pigFRfS0oMYmwSlM1747381604.png", "https://image.prepladder.com/content/f2Cw582Pu7lX5pPvobah1747381613.png", "https://image.prepladder.com/content/UgxCeXUuSSYN9zrtzX1L1747381650.png", "https://image.prepladder.com/content/6Xgw8hgwjWPaq67te1GM1747381631.png", "https://image.prepladder.com/content/o1lTs0Sw9A3ndLSCEUoq1747381718.png", "https://image.prepladder.com/content/ERZPUuSWGDSYhSJ2YXHM1747381745.png", "https://image.prepladder.com/content/i0neA6MH6ApouRlqDGSQ1747381773.png", "https://image.prepladder.com/content/7t73gSyTT1I5cCLd38wS1747381780.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:607px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Osteoporosis circumscripta:</strong> A <span class=\"customMeta\" data-dictid=\"89aa50eac91692777184c8f668d2cf\">circumscribed</span> patch of <span class=\"customMeta\" data-dictid=\"4c8be6d6b716927771948551f98378\">osteoporosis</span> in the skull.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Courtesy of Radiopaedia.org, rID: 7477\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.orthopaedia.com/pagets-disease/\" data-tags=\"\" height=\"371\" src=\"https://image.prepladder.com/content/hIFIpkawgXWjpYlGNvGl1747381369.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\" Yi-Jin Kuok\" data-hash=\"\" data-license=\"CC BY NC SA 3.0\" data-source=\"https://pacs.de/term/osteoporosis-circumscripta-cranii#&amp;gid=1&amp;pid=2\" data-tags=\"\" height=\"596\" src=\"https://image.prepladder.com/content/qEcu9oUsJvzo3LAsq04H1747381392.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>The cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> appearance of the skull</strong> (due to sclerosis)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Lee Chee Kean, Jeremy P, Simmrat Singh, Azura Mansor\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/b-Skull-radiograph-showed-the-pathognomonic-cotton-wool-appearance_fig3_226558659\" data-tags=\"\" height=\"262\" src=\"https://image.prepladder.com/content/u6kMEYRkpGzspT1zmdzu1747381509.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tam O'Shanter sign</strong>: The skull's expansion and flattened base create the appearance of the skull tilting over the <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> structures (due to the thickening of the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> bone).</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Frank Gaillard \" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/images/295?case_id=2639\" data-tags=\"\" height=\"443\" src=\"https://image.prepladder.com/content/GSKiO5X3jBpfmqhFONH51747381583.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Mapham, J (Sgt), No 5 Army Film &amp; Photographic Unit\" data-hash=\"\" data-license=\"OPEN ACCESS\" data-source=\"https://commons.wikimedia.org/wiki/File:Neil_Ritchie.jpg\" data-tags=\"\" height=\"662\" src=\"https://image.prepladder.com/content/KgEXPJkt40OId0Zs6jqU1747381593.png\" width=\"496\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Blade of grass appearance or candle flame sign:</strong> Flame-shaped <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> extending along the <span class=\"customMeta\" data-dictid=\"665018e7801692777198b82c6c9db8\">shaft</span> of the bone.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Andrew Dixon\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/paget-disease-with-blade-of-grass-sign\" data-tags=\"\" height=\"500\" src=\"https://image.prepladder.com/content/t5S0pigFRfS0oMYmwSlM1747381604.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Picture frame vertebra:</strong></p>\n<p>The <span class=\"customMeta\" data-dictid=\"9c0b99fa0816927772010e947b4ef6\">vertebrae</span> appear enlarged and have a thickened <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> bone due to excessive <span class=\"customMeta\" data-dictid=\"f8406817f21692777183176660cf3d\">bone remodeling</span> and disorganized osteoblastic activity.</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Andrew Dixon\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/vertebral-paget-disease-with-picture-frame-appearance-1\" data-tags=\"\" height=\"580\" src=\"https://image.prepladder.com/content/f2Cw582Pu7lX5pPvobah1747381613.png\" width=\"333\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ivory vertebra:</strong></p>\n<p>The homogeneous, <span class=\"customMeta\" data-dictid=\"76584c702f1692777197ee90a74461\">radiopaque</span> appearance results from increased <span class=\"customMeta\" data-dictid=\"0b2564673b16927771836152f83121\">bone density</span> caused by <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> osteoblastic activity, leading to excessive bone formation.</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"James Heilman, MD,\" data-hash=\"\" data-license=\"CC BY-SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Paget%27s_disease_in_vertebra_on_CT.jpg\" data-tags=\"\" height=\"594\" src=\"https://image.prepladder.com/content/UgxCeXUuSSYN9zrtzX1L1747381650.png\" width=\"556\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lincoln sign or Black Beard sign: </strong>Increased <span class=\"customMeta\" data-dictid=\"c5a32dfd6e1692777197db92b6aea1\">radiotracer</span> <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> in the <span class=\"customMeta\" data-dictid=\"55c062d44f16927771919375042b03\">mandible</span> gives it a distinctive black beard appearance that signifies <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> bone <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> in Pagetâs disease.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Kenneth R. Holmes, R. Davis Holmes , Montgomery Martin, Nicolas Murray\" data-hash=\"\" data-license=\"NA\" data-source=\"https://pubs.rsna.org/doi/full/10.1148/rg.2021200187\" data-tags=\"\" height=\"393\" src=\"https://image.prepladder.com/content/6Xgw8hgwjWPaq67te1GM1747381631.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Banana fractures: </strong>Occur in a region of <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> bone.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Matt A. Morgan\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/banana-fracture-paget-disease-1#image-8980707\" data-tags=\"\" height=\"590\" src=\"https://image.prepladder.com/content/o1lTs0Sw9A3ndLSCEUoq1747381718.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which visual field defect is likely to be caused by the lesion shown in the given radiograph?", "options": [{"label": "A", "text": "Altitudinal defect", "correct": false}, {"label": "B", "text": "Bitemporal hemianopia", "correct": true}, {"label": "C", "text": "Inferior arcuate scotoma", "correct": false}, {"label": "D", "text": "Bjerrum scotoma", "correct": false}], "correct_answer": "B. Bitemporal hemianopia", "question_images": ["https://image.prepladder.com/content/wyEYfh40UpFhqODrQ6fj1724912891.png"], "explanation_images": ["https://image.prepladder.com/content/VxYVGqQpQoKW1QftBZ7D1724929441.JPG"], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"3b17da47ce16927771831d5dde3af3\"&gt;Bitemporal&lt;/span&gt; h\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Using the radiograph provided, which diagnosis is most likely?", "options": [{"label": "A", "text": "Chiari type 1 malformation", "correct": true}, {"label": "B", "text": "Dandy-Walker malformation", "correct": false}, {"label": "C", "text": "Vein of Galen malformation", "correct": false}, {"label": "D", "text": "Corpus callosum agenesis", "correct": false}], "correct_answer": "A. Chiari type 1 malformation", "question_images": ["https://image.prepladder.com/content/TNsKTBFkGAlSLbdIaEsg1724751751.png"], "explanation_images": ["https://image.prepladder.com/content/NTaOYnjxlbzbz1nVpCXn1724751865.png"], "explanation": "<p>Correct Option A - Chiari &lt;span class=\"customMeta\" data-dictid=\"ebcb7136251692777201ef4b5c5718\"&gt;type 1&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old female patient complains of a persistent headache. A CT scan of the head was performed, as shown below. What is the most accurate diagnosis?", "options": [{"label": "A", "text": "Subarachnoid hemorrhage (SAH)", "correct": true}, {"label": "B", "text": "Epidural hemorrhage", "correct": false}, {"label": "C", "text": "Subdural hemorrhage", "correct": false}, {"label": "D", "text": "Intraparenchymal hemorrhage", "correct": false}], "correct_answer": "A. Subarachnoid hemorrhage (SAH)", "question_images": ["https://image.prepladder.com/content/iXtKu4t7KHCLol37hVxF1724748704.png"], "explanation_images": ["https://image.prepladder.com/content/5mE1NLWt2zAwtK378Skw1724842856.png", "https://image.prepladder.com/content/3WNH5T4nGBaqEnbUgUNh1724842873.png", "https://image.prepladder.com/content/cqrUaGYNj1z9jttUlF2y1724842885.png", "https://image.prepladder.com/content/oZFAQghgjbVRFKTr6G7S1724842930.png"], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\"&gt;Subarachnoid&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\"&gt;hemorrhage&lt;/span&gt; (SAH)\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "From the provided MRI, please identify the medical condition observed in the lower back of the newborn, which presents as an abnormal lump.", "options": [{"label": "A", "text": "Meningocele", "correct": true}, {"label": "B", "text": "Myelomeningocele", "correct": false}, {"label": "C", "text": "Spina bifida occulta", "correct": false}, {"label": "D", "text": "Bone cyst", "correct": false}], "correct_answer": "A. Meningocele", "question_images": ["https://image.prepladder.com/content/C5dcFrIQw0brFpIOquzK1697198455.png"], "explanation_images": ["https://image.prepladder.com/content/k7QbZY6zI5GBXUP97rza1684993032.png"], "explanation": "<p>Correct Option A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following: A. Epidural hematoma i. B. Subdural hematoma ii. C. Subarchniod hemorrhage iii. D. Intracerebral hemorrhage iv.", "options": [{"label": "A", "text": "A-i, B-ii, C-iii, D-iv", "correct": false}, {"label": "B", "text": "b. A-ii, B-iv, C-i, D-iii", "correct": true}, {"label": "C", "text": "A-iv, B-iii, C-ii, D-i", "correct": false}, {"label": "D", "text": "A-i, B-iii, C-ii, D-i", "correct": false}], "correct_answer": "B. b. A-ii, B-iv, C-i, D-iii", "question_images": ["https://image.prepladder.com/content/xl5XEd7uibkOnMOodwpD1687757597.png", "https://image.prepladder.com/content/Dvd5eWIu4RrIECyqcyhA1687757597.png", "https://image.prepladder.com/content/UZ3zRjN1IJiq3gxn5GC11687757597.png", "https://image.prepladder.com/content/WbisWyBI9ngov51kqWgV1687757597.png"], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Intracranial Hemorrhage</strong></p>\n</td>\n<td>\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Epidural Hematoma</p>\n</td>\n<td>\n<ul>\n<li>Typically caused by arterial bleeding</li>\n<li><strong>Lens-shaped blood collection </strong>between the skull and the <span class=\"customMeta\" data-dictid=\"826ce1571f1692777186a0b6e02559\">dura</span> mater</li>\n<li>Associated with head trauma or skull fracture</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>Subdural Hematoma</p>\n</td>\n<td>\n<ul>\n<li>Typically caused by <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> bleeding</li>\n<li>Blood collection between the <span class=\"customMeta\" data-dictid=\"826ce1571f1692777186a0b6e02559\">dura</span> <span class=\"customMeta\" data-dictid=\"aaae314d6f1692777191e3350c8ade\">mater</span> and the <span class=\"customMeta\" data-dictid=\"dd3534c97c16927771823c0d04f685\">arachnoid</span> mater</li>\n<li>Can be acute, subacute, or chronic</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>Subarachnoid Hemorrhage</p>\n</td>\n<td>\n<ul>\n<li>Bleeding into the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space</li>\n<li>Can result from ruptured aneurysms or head trauma</li>\n<li>Often presents with a sudden severe headache</li>\n<li>May be associated with neck <span class=\"customMeta\" data-dictid=\"b52ddf2a451692777199b4d38e5c53\">stiffness</span> or photophobia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>Intracerebral Hemorrhage</p>\n</td>\n<td>\n<ul>\n<li>Bleeding within the brain tissue itself</li>\n<li>Can be caused by hypertension, trauma, or other underlying conditions</li>\n<li>Symptoms depend on the location and extent of the bleed, such as weakness, numbness, or changes in consciousness</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please determine the anatomical structure indicated in the provided MRI scan.", "options": [{"label": "A", "text": "Midbrain", "correct": false}, {"label": "B", "text": "Cerebellum", "correct": true}, {"label": "C", "text": "Brainstem", "correct": false}, {"label": "D", "text": "Cerebrum", "correct": false}], "correct_answer": "B. Cerebellum", "question_images": ["https://image.prepladder.com/content/Kf8P4broqwbCwXlw63Iq1687760042.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A child presents with left to right shunt and high output cardiac failure . The following is his MRA . What is the diagnosis?", "options": [{"label": "A", "text": "Vein of Galen malformation", "correct": true}, {"label": "B", "text": "Dandy Walker syndrome", "correct": false}, {"label": "C", "text": "Pneumocephalus", "correct": false}, {"label": "D", "text": "Venous sinus thrombosis", "correct": false}], "correct_answer": "A. Vein of Galen malformation", "question_images": ["https://image.prepladder.com/content/GfBADyVFw1Q8ommnl5RK1691499119.png"], "explanation_images": [], "explanation": "<p>Correct Option A: Vein of G\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the pathology in the shown CT:", "options": [{"label": "A", "text": "Intraventricular bleed", "correct": false}, {"label": "B", "text": "Massive Epidural hemorrhage", "correct": true}, {"label": "C", "text": "Subdural hemorrhage", "correct": false}, {"label": "D", "text": "Subarachnoid hemorrhage", "correct": false}], "correct_answer": "B. Massive Epidural hemorrhage", "question_images": ["https://image.prepladder.com/content/PqaVkz6ACBfZPSaDerwX1691479391.png"], "explanation_images": [], "explanation": "<p>Correct Option B\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Type of Brain Hemorrhage</strong></p>\n</td>\n<td>\n<p><strong>Appearance on CT Scan</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Epidural Hemorrhage</p>\n</td>\n<td>\n<p>Convex, lens-shaped collection of blood located between the skull and the <span class=\"customMeta\" data-dictid=\"826ce1571f1692777186a0b6e02559\">dura</span> mater. Appears hyperdense.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Subdural Hemorrhage</p>\n</td>\n<td>\n<p>Crescent-shaped collection of blood between the <span class=\"customMeta\" data-dictid=\"826ce1571f1692777186a0b6e02559\">dura</span> <span class=\"customMeta\" data-dictid=\"aaae314d6f1692777191e3350c8ade\">mater</span> and the brain. Appears hyperdense.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Subarachnoid Hemorrhage</p>\n</td>\n<td>\n<p>Diffuse or <span class=\"customMeta\" data-dictid=\"8fb8df140b1692777191702bbc9358\">localized</span> areas of high-density blood within the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Intracerebral Hemorrhage</p>\n</td>\n<td>\n<p>Irregular-shaped areas of high-density blood within the brain tissue.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Intraventricular Hemorrhage</p>\n</td>\n<td>\n<p>Hyperdense areas of blood accumulation within the brain's ventricles.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Traumatic <span class=\"customMeta\" data-dictid=\"a479c9f4081692777187a3308ccd27\">Extradural</span> Hemorrhage</p>\n</td>\n<td>\n<p>Collection of blood between the skull and the <span class=\"customMeta\" data-dictid=\"826ce1571f1692777186a0b6e02559\">dura</span> <span class=\"customMeta\" data-dictid=\"aaae314d6f1692777191e3350c8ade\">mater</span> caused by trauma. Appears hyperdense.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Hypertensive <span class=\"customMeta\" data-dictid=\"c7f167b8df1692777190bcd90fe428\">Intracerebral</span> Hemorrhage</p>\n</td>\n<td>\n<p>Areas of high-density blood within the brain tissue, often in deep structures like the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Aneurysmal <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">Subarachnoid</span> Hemorrhage</p>\n</td>\n<td>\n<p>Diffuse or <span class=\"customMeta\" data-dictid=\"8fb8df140b1692777191702bbc9358\">localized</span> areas of high-density blood within the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space, typically associated with the <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> of an <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> aneurysm.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 33 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 35 y/o woman presents with an incidental liver mass found on ultrasound. Further imaging with CT and MRI is performed, revealing a well-defined mass with a central scar which is hyperintense on T2w MRI. The lesion shows hot spot on sulphur colloid scan. Which of the following diagnoses is most likely?", "options": [{"label": "A", "text": "Hepatic adenoma", "correct": false}, {"label": "B", "text": "Hepatocellular carcinoma", "correct": false}, {"label": "C", "text": "Focal nodular hyperplasia (FNH)", "correct": true}, {"label": "D", "text": "Fibrolamellar carcinoma (FLC)", "correct": false}], "correct_answer": "C. Focal nodular hyperplasia (FNH)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/QWBXSCgm2ehs9rQuPAwO1744398286.png", "https://image.prepladder.com/notes/dIUoL2zm1MnbVRy86MN71744398324.png", "https://image.prepladder.com/notes/kqEOfpz0TQ7Ji50UEd0x1744398361.png", "https://image.prepladder.com/notes/HSWraBYxvDUXPyOgFnyu1744398398.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>FNH</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>FLC </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Ultrasound</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is difficult to detect as it has similar reflectivity to the liver.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Solid, <span class=\"customMeta\" data-dictid=\"165957ab9c16927771899a331e37b0\">hyperechoic</span> lesions, central <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> and <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> may be seen</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>CT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Well-defined <span class=\"customMeta\" data-dictid=\"61f84221371692777191a8e70c449c\">lobulated</span> mass, isoattenuating to liver parenchyma; marked <span class=\"customMeta\" data-dictid=\"d9ec45007b1692777189e3b26e44ca\">homogeneous</span> <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> in the arterial phase with a central low-attenuation scar, mass effect visible. <strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Well-defined mass, often hyperattenuating; may enhance the arterial phase  <strong>(Option D ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>MRI</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Isointense on T1, <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> on T2; central <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> on T1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hyperintense on T1 if fat-containing, significant <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> on arterial phase.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Key Differentiator</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Central <span class=\"customMeta\" data-dictid=\"41b4e6c32f169277719986f77fbe28\">stellate</span> scar: Enhances on CT/MRI; no calcification</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Scar+ , calcification more common </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DgkeItdFGjxsuXCo3eJH1748756256.mp3", "video": ""}, {"text": "Which of the following is the hallmark radiological feature of primary sclerosing cholangitis (PSC) on MRCP?", "options": [{"label": "A", "text": "Diffuse dilation of bile ducts", "correct": false}, {"label": "B", "text": "Beaded appearance due to alternating strictures and dilations", "correct": true}, {"label": "C", "text": "A single long stricture in the common bile duct", "correct": false}, {"label": "D", "text": "Multiple large masses in the liver", "correct": false}], "correct_answer": "B. Beaded appearance due to alternating strictures and dilations", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/cUIYr88n07MjD8qysghB1744390747.png", "https://image.prepladder.com/notes/oNxlBPRkpiRaYEAfV1Pu1744390790.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Gwcs1SESUGH76QnPKBJE1748758614.mp3", "video": ""}, {"text": "A 55-year-old male with a history of chronic hepatitis presents with abdominal discomfort. Ultrasound shows a heterogeneous liver mass with a \"nodule-in-nodule\" appearance. CT reveals a hypervascular lesion with mosaic enhancement and washout on delayed phases. MRI demonstrates decreased T1 and increased T2 signal intensities with late arterial enhancement. Based on the imaging findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Focal Nodular Hyperplasia (FNH)", "correct": false}, {"label": "B", "text": "Hepatocellular Carcinoma (HCC)", "correct": true}, {"label": "C", "text": "Hepatic Adenoma", "correct": false}, {"label": "D", "text": "Metastatic Liver Disease", "correct": false}], "correct_answer": "B. Hepatocellular Carcinoma (HCC)", "question_images": ["https://image.prepladder.com/notes/CLfPUzjOCWjnNg2SCpXJ1744473446.png", "https://image.prepladder.com/notes/dF3PTWcVyS98xbfrr6KL1744473490.png", "https://image.prepladder.com/notes/R28TOpqxd9YfxOvvrgOw1744609155.png"], "explanation_images": ["https://image.prepladder.com/notes/8qoSjMINslHh5KgNQWwk1744391515.png", "https://image.prepladder.com/notes/fPYqPIv14J7mArVKKcoS1744391554.png", "https://image.prepladder.com/notes/bFMYDYL4yD6r253flujo1744391586.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Ultrasound (USG)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>CT</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>MRI</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>⢠<span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">Heterogeneous</span> mass appearance.</p>\n<p>⢠May display a \"nodule-in-nodule\" pattern.</p>\n<p><img alt=\"RA583\" data-author=\"\" data-hash=\"9571\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/8qoSjMINslHh5KgNQWwk1744391515.png\"/></p>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠<span class=\"customMeta\" data-dictid=\"9d86b5aa821692777189c750eca8c5\">Hypervascular</span> with <span class=\"customMeta\" data-dictid=\"50c786f6e01692777192426797d791\">mosaic</span> enhancement.</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"67d67b341916927772029cd0d951df\">Washout</span> of contrast observed in the <span class=\"customMeta\" data-dictid=\"a74252404f1692777196d3f24bde2d\">portal</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> or delayed phases.</p>\n<p><img alt=\"RA584\" data-author=\"\" data-hash=\"9573\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/fPYqPIv14J7mArVKKcoS1744391554.png\"/></p>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠T1:</strong> Decreased signal intensity.</p>\n<p><strong>⢠T2:</strong> Increased signal intensity.</p>\n<p><strong>⢠Contrast Phases:</strong></p>\n<p>⌠Late arterial phase: Hyperenhancement.</p>\n<p>⌠<span class=\"customMeta\" data-dictid=\"a74252404f1692777196d3f24bde2d\">Portal</span> venous/delayed phase: Washout, indicating malignancy.</p>\n<p><img alt=\"RA585\" data-author=\"\" data-hash=\"9574\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/bFMYDYL4yD6r253flujo1744391586.png\"/></p>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65 y/o diabetic male presents with severe right upper quadrant pain, fever, and signs of sepsis. A USG reveals highly echogenic reflectors with dirty shadowing and ring-down artefacts in the gallbladder. Subsequent CT imaging demonstrates gas within the gallbladder wall and pneumoperitoneum. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic cholecystitis", "correct": false}, {"label": "B", "text": "Acute calculous cholecystitis", "correct": false}, {"label": "C", "text": "Emphysematous cholecystitis", "correct": true}, {"label": "D", "text": "Gallbladder adenocarcinoma", "correct": false}], "correct_answer": "C. Emphysematous cholecystitis", "question_images": ["https://image.prepladder.com/notes/PBchvmxSENFcCM1LvD4b1744473575.jpeg"], "explanation_images": ["https://image.prepladder.com/notes/VQOlJsbN0jf521FP432e1744392498.png", "https://image.prepladder.com/notes/TD11xYE1KlMftjzTOTHp1744392538.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55 y/o perimenopausal woman presents with vague abdominal pain. A CT scan of the abdomen reveals a large, multilocular cystic lesion in the tail of the pancreas with thick septations and peripheral calcifications. Lab results show elevated CEA levels. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pseudocyst", "correct": false}, {"label": "B", "text": "Mucinous Cystic Neoplasm (MCN)", "correct": true}, {"label": "C", "text": "Serous Cystic Neoplasm (SCN)", "correct": false}, {"label": "D", "text": "Intraductal Papillary Mucinous Neoplasm (IPMN)", "correct": false}], "correct_answer": "B. Mucinous Cystic Neoplasm (MCN)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/LzoZJl04ZHfwo9sz3RtU1744392803.png", "https://image.prepladder.com/notes/SdChvbq6sgv7LXIGoJIt1744392886.png", "https://image.prepladder.com/notes/8hV356FbEjWl1sv73eND1744392930.png", "https://image.prepladder.com/notes/McfrDmTTdZT3Tf0x1GSz1744392978.png", "https://image.prepladder.com/notes/F4cRBvqrodnL3b7Fky5L1744393040.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Pseudocysts</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Fluid contains high amylase</p>\n<p>⢠Post-inflammatory, non-neoplastic.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Serous <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">Cystic</span> <span class=\"customMeta\" data-dictid=\"1622f69a94169277719372b76236ca\">Neoplasm</span> (SCN)</strong></p>\n<p><img alt=\"RA575\" data-author=\"\" data-hash=\"9597\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"339\" src=\"https://image.prepladder.com/notes/SdChvbq6sgv7LXIGoJIt1744392886.png\" width=\"400\"/></p>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Common Site:</strong> Head of the pancreas.</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> Features</strong>: Multiple small cysts, sometimes with central <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> calcification.Honeycomb pattern, possible <span class=\"customMeta\" data-dictid=\"41b4e6c32f169277719986f77fbe28\">stellate</span> scar.</p>\n<p><strong>⢠Benign</strong>: Rarely malignant.</p>\n<p><strong>⢠Common in</strong>: Older women in their 6-s-70s - hence called grandmother tumour.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Mucinous <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">Cystic</span> <span class=\"customMeta\" data-dictid=\"1622f69a94169277719372b76236ca\">Neoplasm</span> (MCN)</strong></p>\n<p><img alt=\"RA576\" data-author=\"\" data-hash=\"9598\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"372\" src=\"https://image.prepladder.com/notes/8hV356FbEjWl1sv73eND1744392930.png\" width=\"400\"/></p>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Common Site:</strong> Tail of the pancreas.</p>\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> Features</strong>: Large, multilocular, thick septations, <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> calcifications, and sometimes solid components.</p>\n<p><strong>⢠Risk</strong>: <span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\">Malignant</span> transformation</p>\n<p><strong>⢠Common in</strong>: Perimenopausal women (40-60 years-Mother tumour.)</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Intraductal <span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\">Papillary</span> <span class=\"customMeta\" data-dictid=\"2f72b35d711692777193801d8e084d\">Mucinous</span> <span class=\"customMeta\" data-dictid=\"1622f69a94169277719372b76236ca\">Neoplasm</span> (IPMN)</strong></p>\n<p><img alt=\"RA577\" data-author=\"\" data-hash=\"9599\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"339\" src=\"https://image.prepladder.com/notes/McfrDmTTdZT3Tf0x1GSz1744392978.png\" width=\"400\"/></p>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Types</strong>: Main duct, branch duct, mixed.</p>\n<p><strong>⢠Common Site:</strong> Ductal originâmain <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> or branch duct.</p>\n<p><strong>⢠Risk</strong>: Higher <span class=\"customMeta\" data-dictid=\"0c7efd2b8716927771914c8cb19e54\">malignancy</span> risk in main <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> type.</p>\n<p><strong>⢠Main <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> IPMNs</strong>: Show <strong>cystic dilatation</strong> of the main duct, <strong>enhancing <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">mural</span> nodules</strong>, and <strong>viscid mucus</strong> causing obstruction.</p>\n<p>⢠Protruding <span class=\"customMeta\" data-dictid=\"3c1c3aa8b91692777181989b80fab8\">ampulla</span> of Vater-Fish mouth appearance</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Solid <span class=\"customMeta\" data-dictid=\"d625c104cc1692777196f5e31e17ae\">Pseudopapillary</span> Tumor (SPT)</strong>:</p>\n<p><img alt=\"RA578\" data-author=\"\" data-hash=\"9601\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"319\" src=\"https://image.prepladder.com/notes/F4cRBvqrodnL3b7Fky5L1744393040.png\" width=\"400\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> Features</strong>: Large, encapsulated, solid and <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> mass, often with haemorrhage &amp;necrosis.</p>\n<p><strong>⢠Demographics</strong>: Young women (Daughter tumour), particularly in Asian and African-American populations.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60 y/o man presents with recurrent abdominal pain and jaundice. A CT abdomen reveals a \"sausage-shaped\" pancreas and long segmental pancreatic duct strictures. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic pancreatitis", "correct": false}, {"label": "B", "text": "Autoimmune pancreatitis", "correct": true}, {"label": "C", "text": "Necrotizing pancreatitis", "correct": false}, {"label": "D", "text": "Pancreatic pseudocyst", "correct": false}], "correct_answer": "B. Autoimmune pancreatitis", "question_images": ["https://image.prepladder.com/notes/QQRa4bpQXzUXxQ3ilLVA1744393783.png"], "explanation_images": ["https://image.prepladder.com/notes/jjdx25bNlbpVSDjzxNnq1744393843.png", "https://image.prepladder.com/notes/g6uX73uwWYAxM033gFRM1744393894.png", "https://image.prepladder.com/notes/kRNDrM8OpEnnymhCuXYA1744394033.png", "https://image.prepladder.com/notes/9qC3FHRRlPwmM5Nhev8l1744393986.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Chronic pancreatitis</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Autoimmune Pancreatitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CT scan</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Calcifications</strong> within the pancreas.</p>\n<p><strong>⢠Pancreatic atrophy</strong> with dilated ductal system.</p>\n<p>⢠Irregularities or strictures of the pancreatic duct.</p>\n<p><img alt=\"RA567\" data-author=\"\" data-hash=\"9613\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/jjdx25bNlbpVSDjzxNnq1744393843.png\"/></p>\n<p> </p>\n<p><img alt=\"RA568\" data-author=\"\" data-hash=\"9614\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/g6uX73uwWYAxM033gFRM1744393894.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠<span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">Diffuse</span> pancreatic <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> (\"<strong>sausage-shaped</strong>\" appearance).</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"d9ec45007b1692777189e3b26e44ca\">Homogeneous</span> delayed <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> of the pancreas.</p>\n<p><strong>⢠Capsule-like rim</strong> of low density, suggesting <span class=\"customMeta\" data-dictid=\"60f94bccfb169277719504d6185470\">peripancreatic</span> <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> or fibrosis.</p>\n<p>⢠Ductal narrowing or strictures </p>\n<p> </p>\n<p><img alt=\"RA569\" data-author=\"\" data-hash=\"9617\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/kRNDrM8OpEnnymhCuXYA1744394033.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>MRCP</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Characteristic \"<strong>chain of lakes</strong>\" appearance due to <span class=\"customMeta\" data-dictid=\"1b5a7ceea716927771815e7283e571\">alternating</span> strictures and <span class=\"customMeta\" data-dictid=\"29a08d8f9216927771869ed797367e\">dilatation</span> of the pancreatic duct.</p>\n<p><img alt=\"RA570\" data-author=\"\" data-hash=\"9616\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/9qC3FHRRlPwmM5Nhev8l1744393986.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8gT2tei8W3WQZH6ski2x1748779584.mp3", "video": ""}, {"text": "A 45 y/o woman with a history of acute pancreatitis presents with persistent abdominal pain and weight loss. A CT scan performed 5 weeks after her initial episode shows a thick-walled fluid collection containing gas bubbles. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pancreatic pseudocyst", "correct": false}, {"label": "B", "text": "Walled-off necrosis", "correct": true}, {"label": "C", "text": "Abscess", "correct": false}, {"label": "D", "text": "Interstitial edematous pancreatitis", "correct": false}], "correct_answer": "B. Walled-off necrosis", "question_images": ["https://image.prepladder.com/notes/3wLkdIgXCcY1MP8tgmnt1744394319.png"], "explanation_images": ["https://image.prepladder.com/notes/59kqwA4PzzkTrG9p0R1U1744394360.png", "https://image.prepladder.com/notes/x7AuLyM9x1uHy2OfUVga1744394394.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Pseudocyst (Option A)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Walled-off <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">Necrosis</span> (Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Encapsulated</strong> <strong>fluid collection</strong> that develops more than <strong>4 weeks</strong> after <strong>acute pancreatitis.</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Encapsulated</strong> <strong>collection of necrotic material</strong>, which develops after <strong>4 weeks</strong> in <strong>necrotising pancreatitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Gas Presence</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>No gas <strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Gas bubbles may indicate infection</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Peripancreatic space (may extend to mediastinum)</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Pancreatic and/or <span class=\"customMeta\" data-dictid=\"60f94bccfb169277719504d6185470\">peripancreatic</span> tissues</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Imaging findings</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Homogeneous low-attenuation fluid with capsule</p>\n<p><img alt=\"RA564\" data-author=\"\" data-hash=\"9623\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"433\" src=\"https://image.prepladder.com/notes/59kqwA4PzzkTrG9p0R1U1744394360.png\" width=\"500\"/></p>\n<p>CT showing pseudocyst</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Thick-walled collection may show gas on CT</p>\n<p> </p>\n<p><img alt=\"RA565\" data-author=\"\" data-hash=\"9624\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"304\" src=\"https://image.prepladder.com/notes/x7AuLyM9x1uHy2OfUVga1744394394.png\" width=\"500\"/></p>\n<p>CT Showing âwalled off necrosisâ</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Resolution</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Most resolve spontaneously.</p>\n<p>If more than 5 cm or recurrent, <span class=\"customMeta\" data-dictid=\"0f2897698a169277718547496d3325\">cystogastrostomy</span> is done</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Often requires <span class=\"customMeta\" data-dictid=\"dd824a31e71692777186c7f8168998\">drainage</span> or necrosectomy if infected</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Wd26cyi18H9VMn3QkCYK1748779311.mp3", "video": ""}, {"text": "A 52 y/o man diagnosed with necrotizing pancreatitis presents with worsening abdominal pain. A CT scan on day 3 of his illness is performed. What is the most likely imaging finding seen on day 3 in this patient?", "options": [{"label": "A", "text": "Bulky pancreas with mild thickening", "correct": false}, {"label": "B", "text": "Parenchymal calcifications", "correct": false}, {"label": "C", "text": "Non-enhancing areas in the pancreatic body and tail", "correct": true}, {"label": "D", "text": "Homogeneous enhancement of the pancreas", "correct": false}], "correct_answer": "C. Non-enhancing areas in the pancreatic body and tail", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/xgHE0XwArxMhSlU5JFTf1744394910.png", "https://image.prepladder.com/notes/knmdJFT8dYsogb4gfoAr1744394956.png", "https://image.prepladder.com/notes/lUjBYtyhLpfLwxXDy8Uu1744394993.png", "https://image.prepladder.com/notes/YalPLRaADQgMbCmoqZ7U1744395027.png", "https://image.prepladder.com/notes/H9OGTfwmeYCn2oznnAdb1744395065.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Bulky Pancreas</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Enlarged <span class=\"customMeta\" data-dictid=\"2e2fe8c6c116927771946fb9a8adb0\">pancreas</span> with <span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">heterogeneous</span> enhancement.</p>\n<p>⢠Mild thickening of pancreatic tissue.</p>\n<p>⢠Indicative of oedema in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> edematous pancreatitis.</p>\n<p><img alt=\"RA558\" data-author=\"\" data-hash=\"9629\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/xgHE0XwArxMhSlU5JFTf1744394910.png\"/></p>\n<p><strong>CECT revealing bulky pancreas</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Renal <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> sign:</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠The \"renal halo\" sign presents as a high-density outline around the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> indicating the <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> process in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"98ea94d2c01692777194cc5ffee153\">pancreatitis</span> extending toward the left pancreatic tail and left <span class=\"customMeta\" data-dictid=\"bcca994ca11692777194239a21b52c\">pararenal</span> space</p>\n<p><img alt=\"RA559\" data-author=\"\" data-hash=\"9630\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/knmdJFT8dYsogb4gfoAr1744394956.png\"/></p>\n<p><strong>CECT revealing <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> sign</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CT Findings</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Day 1:</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Normally enhancing pancreas</p>\n<p><img alt=\"RA560\" data-author=\"\" data-hash=\"9631\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/lUjBYtyhLpfLwxXDy8Uu1744394993.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Day 3:</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Significant <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> observed.</p>\n<p>⢠The greater part of the pancreatic body and tail shows no enhancement.</p>\n<p><img alt=\"RA561\" data-author=\"\" data-hash=\"9632\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/YalPLRaADQgMbCmoqZ7U1744395027.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Post 2 weeks:</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Gas bubbles in the <span class=\"customMeta\" data-dictid=\"60f94bccfb169277719504d6185470\">peripancreatic</span> collection are consistent with an infected <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> necrotic collection.</p>\n<p><img alt=\"RA562\" data-author=\"\" data-hash=\"9633\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/H9OGTfwmeYCn2oznnAdb1744395065.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/CUhjH2Peehs4veTal0Vd1748778923.mp3", "video": ""}, {"text": "A 50-year-old male presents with severe epigastric pain radiating to his back, ongoing for four days. Serum lipase is elevated. A contrast-enhanced CT scan reveals over 30% pancreatic necrosis, multiple peripancreatic fluid collections, and bilateral pleural effusions. Based on the Modified CT Severity Index (MCTSI) for acute pancreatitis, how would you grade this patientâs condition?", "options": [{"label": "A", "text": "Mild", "correct": false}, {"label": "B", "text": "Moderate", "correct": false}, {"label": "C", "text": "Severe", "correct": true}, {"label": "D", "text": "Very severe", "correct": false}], "correct_answer": "C. Severe", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:573px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Modified CT Severity Index for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> Pancreatitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pancreatic inflammation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Points</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal Pancreas</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intrinsic pancreatic abnormalities with/without <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> changes in <span class=\"customMeta\" data-dictid=\"60f94bccfb169277719504d6185470\">peripancreatic</span> fat</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pancreatic or <span class=\"customMeta\" data-dictid=\"60f94bccfb169277719504d6185470\">peripancreatic</span> fluid collection or <span class=\"customMeta\" data-dictid=\"60f94bccfb169277719504d6185470\">peripancreatic</span> fat necrosis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pancreatic necrosis:-</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>None</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>â¤30%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;30%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extrapancreatic complications (pleural effusion, ascites, <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> complications, GI <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> involvement)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Total</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0-2 Points = Mild</strong></p>\n<p><strong>4-6 = Moderate</strong></p>\n<p><strong>8-10 = Severe</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50 y/o man presents with severe epigastric pain radiating to the back for the past two days. His serum lipase is elevated to five times the normal limit. An abdominal X-ray shows a dilated loop of small intestine near the pancreas. Which of the following is the most likely imaging sign observed on the X-ray in this patient?", "options": [{"label": "A", "text": "Colon cut-off sign", "correct": false}, {"label": "B", "text": "Pneumoperitoneum", "correct": false}, {"label": "C", "text": "Sentinel loop sign", "correct": true}, {"label": "D", "text": "Ground-glass opacity", "correct": false}], "correct_answer": "C. Sentinel loop sign", "question_images": ["https://image.prepladder.com/notes/J63rvA9fs3wMRYeCnTiU1744395435.png"], "explanation_images": ["https://image.prepladder.com/notes/J63rvA9fs3wMRYeCnTiU1744395435.png", "https://image.prepladder.com/notes/zVxBayRbHYJzW0X3Ih7D1744395495.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>X-ray Features</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"f08132bdfb16927771986a66c5d7b6\">Sentinel</span> loop sign (Option C)</strong>: </p>\n<p>⌠Dilated loop of small <span class=\"customMeta\" data-dictid=\"7840cca3ed16927771901d2f6cb32b\">intestine</span> near the inflamed <span class=\"customMeta\" data-dictid=\"2e2fe8c6c116927771946fb9a8adb0\">pancreas</span> due to <span class=\"customMeta\" data-dictid=\"8fb8df140b1692777191702bbc9358\">localized</span> ileus.</p>\n<p><strong>⌠Significance</strong>: Early indicator of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"98ea94d2c01692777194cc5ffee153\">pancreatitis</span> on X-ray.</p>\n<p><img alt=\"RA556\" data-author=\"\" data-hash=\"9637\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/J63rvA9fs3wMRYeCnTiU1744395435.png\"/></p>\n<p>Sentinel loop sign</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"0fce15e71f1692777184feb9af5303\">Colon</span> cut-off sign</strong>: </p>\n<p>⌠Abrupt <span class=\"customMeta\" data-dictid=\"a35c217ec416927772009a7f3b20f4\">termination</span> of gas in the <span class=\"customMeta\" data-dictid=\"0fce15e71f1692777184feb9af5303\">colon</span> at the splenic flexure, with collapsed <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"0fce15e71f1692777184feb9af5303\">colon</span> loops.</p>\n<p><strong>⌠Significance</strong>: Suggests <span class=\"customMeta\" data-dictid=\"8fb8df140b1692777191702bbc9358\">localized</span> pancreatic inflammation, causing <span class=\"customMeta\" data-dictid=\"566fcef0991692777184068f36db82\">colonic</span> <span class=\"customMeta\" data-dictid=\"0338b655da16927771984b872baabb\">spasm</span> as an <span class=\"customMeta\" data-dictid=\"2f73e160ba1692777190d65065c95b\">indirect</span> sign of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> pancreatitis</p>\n<p><img alt=\"RA557\" data-author=\"\" data-hash=\"9639\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/zVxBayRbHYJzW0X3Ih7D1744395495.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/F3nfmX8K318KSsIaeYgf1748778275.mp3", "video": ""}, {"text": "Which investigation is most sensitive for detecting bile leakage but does not provide information about the exact location of the leak?", "options": [{"label": "A", "text": "HIDA Scan", "correct": true}, {"label": "B", "text": "CECT", "correct": false}, {"label": "C", "text": "MRI with Hepatobiliary Contrast", "correct": false}, {"label": "D", "text": "Percutaneous Transhepatic Cholangiography", "correct": false}], "correct_answer": "A. HIDA Scan", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/8M9zzdHbV5Uk7Ap2Qy7y1744395753.png", "https://image.prepladder.com/notes/ktI3e82v1wbBjYfKEzjL1744395796.png", "https://image.prepladder.com/notes/aAmn6mXqz6JhWoSM1N5P1744395836.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wnhyXb718s9jFByQumMi1748759028.mp3", "video": ""}, {"text": "A 2-month-old infant presents with persistent jaundice and pale stools. An ultrasound reveals no biliary dilation but shows the \"triangular cord sign.\" Which condition is most likely suggested by this finding?", "options": [{"label": "A", "text": "Choledochal Cyst", "correct": false}, {"label": "B", "text": "Biliary Atresia", "correct": true}, {"label": "C", "text": "Neonatal Hepatitis", "correct": false}, {"label": "D", "text": "Caroliâs Disease", "correct": false}], "correct_answer": "B. Biliary Atresia", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Uf3rYgXQZvNUPQE0Suyk1744396067.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WlQbV8yhWgtaNuvqFhBZ1748758857.mp3", "video": ""}, {"text": "Which of the following statements about imaging modalities used in the liver is FALSE?", "options": [{"label": "A", "text": "USG is the first-line investigation for hepatic disorders.", "correct": false}, {"label": "B", "text": "T1-weighted images show a normal liver as hypointense compared to the spleen and kidney.", "correct": true}, {"label": "C", "text": "CT allows multiphasic examinations, including arterial, portal, and delayed phases.", "correct": false}, {"label": "D", "text": "Digital Subtraction Angiography (DSA) is primarily reserved for therapeutic purposes.", "correct": false}], "correct_answer": "B. T1-weighted images show a normal liver as hypointense compared to the spleen and kidney.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/6rEabq7GWhxYiTIX3yhX1744396313.png", "https://image.prepladder.com/notes/GFonAx5b3FITNOWd7K8E1744396349.png", "https://image.prepladder.com/notes/jCyIlip77zT0qwhLRb041748780518.png", "https://image.prepladder.com/notes/VmbylCh2d1rULydSJjAX1744396448.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Imaging Techniques of Liver</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Ultrasonography</strong></p>\n<p> </p>\n<p>⢠First-line investigation for <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> disorders. <strong>(Option A ruled out)</strong></p>\n<p>⢠Cost-effective and useful for repeated follow-up.</p>\n<p><strong>⢠Elastography </strong>quantifies liver stiffness.</p>\n<p><strong>⢠Contrast-enhanced USG</strong> evaluates <span class=\"customMeta\" data-dictid=\"05493772261692777201c10c4ee537\">vascularity</span> without radiation exposure.</p>\n<p><strong>⢠Colour Doppler</strong> assesses <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> vessel flow and patency.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA506\" data-author=\"\" data-hash=\"9653\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/6rEabq7GWhxYiTIX3yhX1744396313.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Computed Tomography</strong></p>\n<p> </p>\n<p>⢠Investigation of choice for <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> assessment.</p>\n<p>⢠It is less expensive and more accessible than MRI.</p>\n<p>⢠Excellent for volumetry and <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> feasibility evaluation.</p>\n<p>⢠Allows Triple-phase examinations, including:</p>\n<p>⌠Arterial Phase</p>\n<p>⌠Portal Phase</p>\n<p>⌠Delayed Phase <strong>(Option C ruled out)</strong></p>\n<p>⢠If the <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> is enhanced in the arterial phase, it is <span class=\"customMeta\" data-dictid=\"6165f47a8c1692777188c0dfc0d75d\">hepatocellular</span> carcinoma.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA507\" data-author=\"\" data-hash=\"9654\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/GFonAx5b3FITNOWd7K8E1744396349.png\"/></p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Magnetic Resonance Imaging</strong></p>\n<p> </p>\n<p>⢠Best for assessing liver <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> and <span class=\"customMeta\" data-dictid=\"7dd6eda7ce169277718325f22de9e8\">biliary</span> system.</p>\n<p>⢠Excellent soft tissue resolution.</p>\n<p>⢠Effective in evaluating <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> liver conditions like <span class=\"customMeta\" data-dictid=\"51930ddfeb169277719982af86ec99\">steatosis</span> and fibrosis.</p>\n<p>⢠Uses gadolinium-based contrast agents (e.g., Gd-DTPA, Gd-DOTA) for T1 enhancement.</p>\n<p>⢠Breath-hold 3D T1 weighted sequences allow multiphasic examinations similar to CT.</p>\n<p>⢠Hepatobiliary-specific agents target the reticulo-endothelial system (RES) or hepatocytes.</p>\n<p><strong>⢠T1-Weighted Images</strong></p>\n<p>⌠Normal Liver Parenchyma: <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">Hyperintense</span> compared to muscle, spleen, and kidney.</p>\n<p>⌠Pathological Lesions: Typically T1 <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> due to higher water or <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">cellular</span> density.</p>\n<p><strong>⢠T2-Weighted Images</strong></p>\n<p>⌠Normal Liver Signal: <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">Hypointense</span> compared to spleen, kidney, and pancreas.</p>\n<p>⌠Lesions: Usually hyperintense, aiding in detection.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"MRI liver\" data-author=\"\" data-hash=\"13285\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/jCyIlip77zT0qwhLRb041748780518.png\"/></p>\n<p><strong>MRI revealed multiple metastatic liver tumours</strong></p>\n<p>A- T1 MRI, B- T2 MRI</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Digital Subtraction Angiography</strong></p>\n<p> </p>\n<p>⢠Largely reserved for <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> purposes. <strong>(Option D ruled out)</strong></p>\n<p>⢠Has been superseded by CT and MR angiographies for diagnostics.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA509\" data-author=\"\" data-hash=\"9656\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/VmbylCh2d1rULydSJjAX1744396448.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n<p><strong>References:</strong></p>\n<ul><li>âł David Sutton Textbook of Radiology and Imaging, Volume 1, 8th edition, Page 2355- 2357</li><li>âł Grainger and Allisonâs Textbook of Diagnostic Radiology, 7th edition, Page 599-606</li><li>âł CT triple-phase liver (protocol) | Radiology Reference Article | Radiopaedia.org</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XmUy9OdvTIwc6EDgjudB1749028617.mp3", "video": ""}, {"text": "A 60 y/o jaundiced patient presents with upper abdominal pain. Ultrasound reveals a dilated bile duct, but the cause of obstruction is unclear. What would be the next best non-invasive imaging technique to evaluate this condition?", "options": [{"label": "A", "text": "Magnetic Resonance Cholangiopancreatography (MRCP)", "correct": true}, {"label": "B", "text": "Endoscopic Retrograde Cholangiopancreatography (ERCP)", "correct": false}, {"label": "C", "text": "Ultrasound with colour Doppler", "correct": false}, {"label": "D", "text": "Plain radiography", "correct": false}], "correct_answer": "A. Magnetic Resonance Cholangiopancreatography (MRCP)", "question_images": ["https://image.prepladder.com/notes/EbL2PTYxBUdcdvysVuEy1744396723.png"], "explanation_images": ["https://image.prepladder.com/notes/o0FYaqSsfq6mM6mpjkZ81744396762.png", "https://image.prepladder.com/notes/LOEiKohFQFXKfwku65p11744396815.png", "https://image.prepladder.com/notes/9AAfx8mT68AI8Vcp9l0O1744396850.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Y7v6OvLQImStbzb9pRUI1748758223.mp3", "video": ""}, {"text": "A 45-year-old woman presents with intermittent right upper quadrant pain. An ultrasound shows echogenic foci with posterior acoustic shadowing. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Gallbladder polyp", "correct": false}, {"label": "B", "text": "Gallbladder calculus", "correct": true}, {"label": "C", "text": "Gallbladder adenomyomatosis", "correct": false}, {"label": "D", "text": "Porcelain gallbladder", "correct": false}], "correct_answer": "B. Gallbladder calculus", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/sApXsVKk71AS2QjI13GZ1744397078.png", "https://image.prepladder.com/notes/4L2S5gZbp0UfNz0OmfwD1744397120.png", "https://image.prepladder.com/notes/rfZr5onz5ALGtt5CFzyY1744397160.png", "https://image.prepladder.com/notes/wMGALnMgUVV0jS9ejhOw1744397193.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Gallbladder</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Radiology</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Gallbladder calculus</strong></p>\n<p><strong>(Option B)</strong></p>\n<p> </p>\n<p>⢠Gallstones, or GB calculi, are the most likely diagnosis in this case, as they typically appear as<strong> <span class=\"customMeta\" data-dictid=\"91b98150ea169277718629280d911c\">echogenic</span> <span class=\"customMeta\" data-dictid=\"e2071f8f891692777203982b3fa0f5\">foci</span> on <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> and produce <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> shadowing. </strong></p>\n<p>⢠This shadowing is caused by the solid nature of the stones, which block the transmission of sound waves.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA542\" data-author=\"\" data-hash=\"9667\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/sApXsVKk71AS2QjI13GZ1744397078.png\"/></p>\n<p><strong>USG</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Gallbladder polyp</strong></p>\n<p><strong>(Option A ruled out)</strong></p>\n<p> </p>\n<p>⢠They are typically small masses that protrude into the <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> of the gallbladder. </p>\n<p>⢠On ultrasound, they generally appear as smooth, <span class=\"customMeta\" data-dictid=\"165957ab9c16927771899a331e37b0\">hyperechoic</span> <span class=\"customMeta\" data-dictid=\"603b3d38051692777190701f192c2a\">intraluminal</span> lesions without <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> shadowing, unlike gallstones.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA543\" data-author=\"\" data-hash=\"9668\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/4L2S5gZbp0UfNz0OmfwD1744397120.png\"/></p>\n<p><strong>USG</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Gallbladder adenomyomatosis</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n<p> </p>\n<p>⢠This is characterised by thickening of the <span class=\"customMeta\" data-dictid=\"1f51bf91811692777188d929c8e851\">gallbladder</span> wall, often due to cholesterol crystals or small stones in the Rokitansky-Aschoff sinuses. </p>\n<p>⢠On ultrasound, <span class=\"customMeta\" data-dictid=\"2672bbac4916927771800822b64bad\">adenomyomatosis</span> presents with a distinctive comet-tail ring-down artefact (due to <span class=\"customMeta\" data-dictid=\"6054db421816927771972b4322bd90\">reverberation</span> from the <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> spaces), which differentiates it from simple shadowing seen with gallstones.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA544\" data-author=\"\" data-hash=\"9669\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/rfZr5onz5ALGtt5CFzyY1744397160.png\"/></p>\n<p><strong>USG</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Porcelain gallbladder</strong></p>\n<p><strong>(Option D ruled out)</strong></p>\n<p> </p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"e8d8ca06111692777196997de5e559\">Porcelain</span> <span class=\"customMeta\" data-dictid=\"1f51bf91811692777188d929c8e851\">gallbladder</span> refers to a calcified <span class=\"customMeta\" data-dictid=\"1f51bf91811692777188d929c8e851\">gallbladder</span> wall, which appears as a dense shadowing structure on imaging, typically seen on plain radiographs or CT scans.</p>\n<p>⢠It is associated with <span class=\"customMeta\" data-dictid=\"1f51bf91811692777188d929c8e851\">gallbladder</span> carcinoma.</p>\n<p>⢠ Ultrasound findings of <span class=\"customMeta\" data-dictid=\"e8d8ca06111692777196997de5e559\">porcelain</span> GB can resemble emphysematous <span class=\"customMeta\" data-dictid=\"180ce1a7c416927771844825c616f4\">cholecystitis</span> or large stones, but the condition is characterised by the absence of the double-arc shadow sign seen with gallstones.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA545\" data-author=\"\" data-hash=\"9671\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/wMGALnMgUVV0jS9ejhOw1744397193.png\"/></p>\n<p><strong>CT</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9TNKdRiNswybKzqX7JRd1748757870.mp3", "video": ""}, {"text": "A 45 y/o woman presents with right upper quadrant pain and fever. Ultrasound shows gallbladder wall thickening, gallstones, and pericholecystic fluid. Which of the following findings would most likely suggest chronic cholecystitis rather than acute cholecystitis?", "options": [{"label": "A", "text": "Positive sonographic Murphy sign", "correct": false}, {"label": "B", "text": "Absence of pericholecystic fluid", "correct": true}, {"label": "C", "text": "High-density bile on CT", "correct": false}, {"label": "D", "text": "Gallbladder distension on computed tomography (CT)", "correct": false}], "correct_answer": "B. Absence of pericholecystic fluid", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/LIb2HlwNR76IL75dCuPN1744397407.png", "https://image.prepladder.com/notes/IuVWPtza4sTKJpZsxDbp1744397454.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Acute Cholecystitis</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Chronic Cholecystitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Gallstones</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Present</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Absent</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Gallbladder Wall Thickening</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Pronounced</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Mild</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Pericholecystic Fluid/Inflammation</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Common</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Rare <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Functional <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> (CCK-Cholescintigraphy)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Not commonly used</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Impaired <span class=\"customMeta\" data-dictid=\"3d46029a83169277718580263882c3\">contractility</span> (&lt;35% EF) is diagnostic.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HyhJMM5aDjlQX4sFNMB21748757703.mp3", "video": ""}, {"text": "Which of the following statements about gallstones is correct?", "options": [{"label": "A", "text": "Cholesterol stones are typically radiopaque and easily visible on X-rays.", "correct": false}, {"label": "B", "text": "The Mercedes-Benz sign refers to a star-shaped pattern of gas fissuring in gallstones seen on imaging.", "correct": true}, {"label": "C", "text": "Pigment stones are primarily composed of cholesterol and easily visible on X-ray.", "correct": false}, {"label": "D", "text": "All gallstones require immediate surgical intervention.", "correct": false}], "correct_answer": "B. The Mercedes-Benz sign refers to a star-shaped pattern of gas fissuring in gallstones seen on imaging.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/47ohm5wHIJCtE1Ay3QYa1744397649.png", "https://image.prepladder.com/notes/mH3zR0EM1Aq6n3Zpofzq1744397682.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gallstones</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Renal Stones</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Composed of cholesterol, bilirubin, and <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> salts.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Comprises various minerals: <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> oxalate, <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid, struvite, and cystine.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gallstones are better visualised on USG.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Renal stones are better seen on CT</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cholesterol stones may be hard to see on X-rays but are identifiable via <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> due to <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> shadows. <strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uric acid stones require non-contrast CT for detection, as they may not show on X-rays.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnostic <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> Techniques</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gallstones</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Renal Stones</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>USG: </strong>Commonly used; no ionising radiation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>USG: </strong>Limited use.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT Scans: </strong>Highly sensitive for both stones.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT Scans: </strong>Highly sensitive, detects small/radiolucent stones.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-rays: </strong>Limited effectiveness.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-rays: </strong>Effective for <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> <span class=\"customMeta\" data-dictid=\"28ddbfbaa51692777194aa6875fac4\">oxalate</span> stones.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4VjUTI3L5d8pcE2HGR971748757114.mp3", "video": ""}, {"text": "A 45 y/o man from an endemic region presents with abdominal pain. An ultrasound reveals a cyst with multiple septations, resembling a honeycomb. Based on the WHO classification, which of the following stages does this hydatid cyst most likely represent?", "options": [{"label": "A", "text": "CE1", "correct": false}, {"label": "B", "text": "CE2", "correct": true}, {"label": "C", "text": "CE3a", "correct": false}, {"label": "D", "text": "CE5", "correct": false}], "correct_answer": "B. CE2", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/LFR4AKc1xIzrMWXGuBWD1744397884.png", "https://image.prepladder.com/notes/tPbCtEF8UmyA3PrTPT5n1744397914.png", "https://image.prepladder.com/notes/XfWo4FM5Rts81p9XkCSV1744397943.png", "https://image.prepladder.com/notes/usoAkmS0p193ISRqjNoD1744397974.png", "https://image.prepladder.com/notes/JvH5n0aF2aEkNMAx7dAZ1744398002.png", "https://image.prepladder.com/notes/LXY9JdVSVJrozr6O6POv1744398032.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td colspan=\"4\" rowspan=\"1\" style=\"vertical-align:top\">\n<p style=\"text-align:center\"><strong>WHO Classification</strong></p>\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\"> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Gharbi classification</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Classification</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Stage</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Classification</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE1 (Option A ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Unilocular <span class=\"customMeta\" data-dictid=\"acb59b05f31692777181d2df5f618b\">anechoic</span> <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> with a 'double line' sign.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA532\" data-author=\"\" data-hash=\"9677\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/LFR4AKc1xIzrMWXGuBWD1744397884.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Active</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type I</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE2 (Option B)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Cyst with multiple septations, resembling a honeycomb.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA533\" data-author=\"\" data-hash=\"9678\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/tPbCtEF8UmyA3PrTPT5n1744397914.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Active</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type III</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE3a (Option C ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Unilocular <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> with detached membranes and 'water-lily' sign.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA534\" data-author=\"\" data-hash=\"9679\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/XfWo4FM5Rts81p9XkCSV1744397943.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Transitional</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type II</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE3b</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Cyst with daughter cysts in a solid matrix.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA535\" data-author=\"\" data-hash=\"9680\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/usoAkmS0p193ISRqjNoD1744397974.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Transitional</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type III</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE4</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Heterogeneous echogenicity, no daughter cysts indicating degeneration.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA536\" data-author=\"\" data-hash=\"9682\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/JvH5n0aF2aEkNMAx7dAZ1744398002.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Inactive</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type IV</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE5 (Option D ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Calcified cyst, indicating inactivity.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA537\" data-author=\"\" data-hash=\"9683\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/LXY9JdVSVJrozr6O6POv1744398032.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Inactive</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type V</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VgZQ16cYGZC4Zhw5hZMH1748756686.mp3", "video": ""}, {"text": "Match the following with their respective radiologic images Radiological Imaging Diagnosis a. 1. Caroliâs Disease b. 2. HCC c. 3. Hepatic Cyst d. 4. Hepatic Hemangioma", "options": [{"label": "A", "text": "a-2; b-3; c-4; d-1", "correct": false}, {"label": "B", "text": "a-3; b-4; c-1; d-2", "correct": true}, {"label": "C", "text": "a-4; b-3; c-1; d-2", "correct": false}, {"label": "D", "text": "a-1; b-4; c-3; d-2", "correct": false}], "correct_answer": "B. a-3; b-4; c-1; d-2", "question_images": ["https://image.prepladder.com/notes/OjPed0iOUPpHz7FOuajK1744436572.png", "https://image.prepladder.com/notes/JleMHLnYQ04pPTEwCDux1744436635.png", "https://image.prepladder.com/notes/4vx9xI4BMksRspcxfxrU1749097501.PNG", "https://image.prepladder.com/notes/NkjlmUbppkXau5xteZ0V1749097686.PNG"], "explanation_images": ["https://image.prepladder.com/notes/wGpi09RDOhfyvx0vJH441744437056.png", "https://image.prepladder.com/notes/hBMZQ4SCSOZtkCFhZ0mH1744437102.png", "https://image.prepladder.com/notes/4vx9xI4BMksRspcxfxrU1749097501.PNG", "https://image.prepladder.com/notes/0VhLUGmWgpRx93WO7GeZ1749098118.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ultrasound</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hepatic Cysts</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spherical, homogenous, no echoes or Doppler</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0-10 HU, no <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> on IV contrast, high <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> if an infection is present.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypointense on T1, <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> on T2, no <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> with IV Gd-DTPA</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hepatic Hemangiomas </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Well-defined, echogenic, no Doppler signal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Well-defined, <span class=\"customMeta\" data-dictid=\"61f84221371692777191a8e70c449c\">lobulated</span> lesions. <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">Peripheral</span> enhancement, <span class=\"customMeta\" data-dictid=\"a806a06e94169277718460a7d4af2f\">centripetal</span> filling.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Most sensitive. </strong>Hyperintense on T2, <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> enhancement.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Caroli's Disease </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Show <span class=\"customMeta\" data-dictid=\"b503deeba816927771880b1d1684ad\">hepatolithiasis</span> as ductal <span class=\"customMeta\" data-dictid=\"29a08d8f9216927771869ed797367e\">dilatation</span> with stones, which lack shadowing.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Communication between <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> ducts and cysts seen on CT</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contrast-enhanced MRCP shows <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> duct-cyst communication</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"><strong>HCC</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Variable echogenicity, \n\t\t\t<table>\n</table>\n\t\t\tHypervascular on Doppler\n\n\t\t\t<table>\n</table>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Arterial hyperenhancement,\n\t\t\t<table>\n</table>\n\t\t\tWashout in portal/delayed phase\n\n\t\t\t<table>\n</table>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">T1 hypointense, T2 mildly hyper, \n\t\t\t<table>\n</table>\n\t\t\tWashout + capsule; <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> on <span class=\"customMeta\" data-dictid=\"8cee6e043d1692777188350a4ab7dd\">hepatobiliary</span> phase\n\n\t\t\t<table>\n</table>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hepatic Adenoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Usually appears as a solitary, well-demarcated <span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">heterogeneous</span> mass.</p>\n<p>Variable echogenicity:</p>\n<p>Hypoechoic <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> (focal <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> sparing) is often seen.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Variable <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> is influenced by haemorrhage (hyperattenuating) or fat content (hypoattenuating).</p>\n<p>Typically well-marginated and isoattenuating;</p>\n<p>May show calcifications in cases of prior hemorrhage.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T1:</strong> Variable intensity (hyper-, iso-, or hypointense); often <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> if non-hemorrhagic.</p>\n<p><strong>T2:</strong> Mildly hyperintense.</p>\n<p><strong>IP/OP:</strong> Fat presence can cause signal dropout on out-of-phase imaging</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table>\n</table>\n<table>\n</table>\n<table>\n</table>\n<table>\n</table>\n<table>\n</table>\n<table>\n\n<p><strong>References:</strong></p>\n<ul><li>âł Reference:</li><li>âł Grainger &amp; Allisonâs Diagnostic Radiology, 7th Edition, Page 612, 613, 615, 628, 629, 673 radiopaedia.org/articles/hepatic-adenoma</li><li>âł Grainger &amp; Allisonâs Diagnostic Radiology, 7th Edition, Page 612, 613, 615, 628, 629, 673</li><li>âł radiopaedia.org/articles/hepatic-adenoma</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old female presents to the hospital for evaluation of recurrent abdominal discomfort over the past few months. She has a history of autosomal dominant polycystic kidney disease. An abdominal MRI reveals multiple irregularly delineated hyper-intense cystic nodules in the liver that do not communicate with the biliary tree. Which of the following statements is true regarding the diagnosis suggested by the MRI findings?", "options": [{"label": "A", "text": "Very commonly associated with malignant transformation.", "correct": false}, {"label": "B", "text": "Typically asymptomatic and often found incidentally.", "correct": true}, {"label": "C", "text": "Characterized by enhancement on contrast CT.", "correct": false}, {"label": "D", "text": "Not associated with Caroliâs disease.", "correct": false}], "correct_answer": "B. Typically asymptomatic and often found incidentally.", "question_images": ["https://image.prepladder.com/notes/5OLII1zrKE8VyHv055bS1744437638.png"], "explanation_images": ["https://image.prepladder.com/notes/5OLII1zrKE8VyHv055bS1744437638.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/okz7EYqLKxIpooUwKvPI1748755389.mp3", "video": ""}, {"text": "From the CT abdomen given below identify the labeled structures.", "options": [{"label": "A", "text": "1- Liver, 2- IVC, 7- Right kidney", "correct": false}, {"label": "B", "text": "4- Aorta, 5- IVC, 7- Left kidney", "correct": false}, {"label": "C", "text": "3- Stomach, 4- IVC, 7- Spleen", "correct": false}, {"label": "D", "text": "2- Gallbladder, 5- Aorta, 6- Left Renal Vein", "correct": true}], "correct_answer": "D. 2- Gallbladder, 5- Aorta, 6- Left Renal Vein", "question_images": ["https://image.prepladder.com/content/CmVaJnbeppk0BM33unnw1741188965.png"], "explanation_images": ["https://image.prepladder.com/notes/W9T4fiYPdDatdJJtF5Xc1744438199.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hODPQ91NbtHKqLCx2YPC1745340666.mp3", "video": ""}, {"text": "A 65 y/o male presents with severe abdominal pain and elevated liver enzymes. After imaging, he is found to have a suspected bile duct obstruction due to a stone. The physician plans to both visualize and potentially treat the obstruction. Which imaging modality should be chosen?", "options": [{"label": "A", "text": "Magnetic Resonance Cholangiopancreatography", "correct": false}, {"label": "B", "text": "Endoscopic Retrograde Cholangiopancreatography", "correct": true}, {"label": "C", "text": "Ultrasound", "correct": false}, {"label": "D", "text": "Computed Tomography", "correct": false}], "correct_answer": "B. Endoscopic Retrograde Cholangiopancreatography", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/eJHA9S0YyNcabMrqbani1744438539.png", "https://image.prepladder.com/notes/si9PbYsI7Y6eKpeYG5NM1744438595.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">Resonance</span> <span class=\"customMeta\" data-dictid=\"81439c0f9716927771841fe69eb19e\">Cholangiopancreatography</span> (MRCP)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Endoscopic Retrograde </strong></p>\n<p><strong>Cholangiopancreatography (ERCP)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠Indications include suspected <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> calculus, cholestasis, pre-surgical <span class=\"customMeta\" data-dictid=\"7dd6eda7ce169277718325f22de9e8\">biliary</span> evaluation, <span class=\"customMeta\" data-dictid=\"7dd6eda7ce169277718325f22de9e8\">biliary</span> leak, unknown aetiology <span class=\"customMeta\" data-dictid=\"0aa16e71201692777198c4c07e2392\">sclerosing</span> cholangitis, and unsuccessful or contraindicated ERCP.</p>\n<p>⢠Not typically used for interventions. <strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠It allows for visual assessment of the <span class=\"customMeta\" data-dictid=\"280e59e9331692777186f3beac2c41\">duodenum</span> and <span class=\"customMeta\" data-dictid=\"3c1c3aa8b91692777181989b80fab8\">ampulla</span> of Vater.</p>\n<p>⢠Allows biopsies, stone extraction, and other Interventional procedures like sphincterotomy, <span class=\"customMeta\" data-dictid=\"7dd6eda7ce169277718325f22de9e8\">biliary</span> stenting, and <span class=\"customMeta\" data-dictid=\"7dd6eda7ce169277718325f22de9e8\">biliary</span> <span class=\"customMeta\" data-dictid=\"329b77e4b11692777199930404f75c\">stricture</span> dilation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Suitability for Jaundice</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>More Suitable for jaundiced patients</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Less suitable for jaundiced patients as it is invasive</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Imaging Type</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Provides <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> and functional information</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Provides dynamic information during contrast introduction</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Success Rate</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Substantially replaces <span class=\"customMeta\" data-dictid=\"5d1cd546ad16927771967fe71128f0\">PTC</span> and ERCP</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Success rates of 92%â97%</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Complication Rates</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Lower complications; no specified rates</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Complication rates of 0.9% to 2.3% (severe)</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Resolution</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Lower <span class=\"customMeta\" data-dictid=\"6495ef882b169277719896942b51c3\">spatial</span> and contrast resolution compared to CT-IVC</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>High <span class=\"customMeta\" data-dictid=\"6495ef882b169277719896942b51c3\">spatial</span> resolution for detailed imaging</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Image</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA512\" data-author=\"\" data-hash=\"9810\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/eJHA9S0YyNcabMrqbani1744438539.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><img alt=\"RA513\" data-author=\"\" data-hash=\"9811\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/si9PbYsI7Y6eKpeYG5NM1744438595.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QoqQ0UIHeXAqnUnrv8cQ1748754965.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 32 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "What condition is indicated by the MRCP image below?", "options": [{"label": "A", "text": "Choledochal cyst", "correct": true}, {"label": "B", "text": "Cholangiocarcinoma", "correct": false}, {"label": "C", "text": "Cholelithiasis", "correct": false}, {"label": "D", "text": "Choledocholithiasis", "correct": false}], "correct_answer": "A. Choledochal cyst", "question_images": ["https://image.prepladder.com/content/B5hC2W5438OaEnLwMInS1724912692.png"], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"dab15cbc3a1692777184db8eae94c4\"&gt;Choledochal&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please determine the segment of the liver that is highlighted in red in the provided image.", "options": [{"label": "A", "text": "V", "correct": true}, {"label": "B", "text": "IVa", "correct": false}, {"label": "C", "text": "VII", "correct": false}, {"label": "D", "text": "III", "correct": false}], "correct_answer": "A. V", "question_images": ["https://image.prepladder.com/notes/4WJ4ywlvAr7fn74b53ds1747383689.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the condition based on the non-contrast CT scan of a patient given below:", "options": [{"label": "A", "text": "Hepatocellular carcinoma", "correct": false}, {"label": "B", "text": "Fibronodular hyperplasia", "correct": false}, {"label": "C", "text": "Liver abscess", "correct": false}, {"label": "D", "text": "Hydatid cyst", "correct": true}], "correct_answer": "D. Hydatid cyst", "question_images": ["https://image.prepladder.com/notes/QpxB3DNAuN3ReOWjYPNa1747060267.png"], "explanation_images": ["https://image.prepladder.com/notes/oBtizXKC1TwrnPk3rO991746691400.png", "https://image.prepladder.com/notes/cmUVTiEsDKlnfPWCHJEg1746691424.png", "https://image.prepladder.com/notes/IzlbD5J9J8y7TAUZpa3X1746691441.png", "https://image.prepladder.com/notes/fhslaJDVIMEBb63QfJZk1746691497.png", "https://image.prepladder.com/notes/GPq4TalHse7XKtq3bPQB1746691519.png", "https://image.prepladder.com/notes/SSowKrqbYk5vEBIpFmRJ1746691535.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td colspan=\"4\" rowspan=\"1\" style=\"vertical-align:top\">\n<p><strong>WHO Classification</strong></p>\n<p> </p>\n<p> </p>\n<p> </p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Gharbi classification</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Classification</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p style=\"text-align:center\"><strong>Imaging</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Stage</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Classification</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE1</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Unilocular <span class=\"customMeta\" data-dictid=\"acb59b05f31692777181d2df5f618b\">anechoic</span> <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> with a 'double line' sign.</p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CE1\" data-author=\"Joachim Richter, Andreas Karl Lindner, Dominik Geisel, Giovanni Federico Torsello, Gabriela Equihua Martinez, Caroline Isner, Dirk SchĂźrmann, Frieder Pfäfflin, Arzu Orhun, Tommaso Manciulli &amp; Enrico Brunetti \" data-hash=\"12384\" data-license=\"CC BY 4.0\" data-source=\"https://link.springer.com/article/10.1007/s12328-021-01397-4\" data-tags=\"May2025\" height=\"422\" src=\"https://image.prepladder.com/notes/oBtizXKC1TwrnPk3rO991746691400.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p>Active</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type I</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE2</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Cyst with multiple septations, resembling a honeycomb.</p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CE2 Hydatid cyst\" data-author=\"Joachim Richter, Andreas Karl Lindner, Dominik Geisel, Giovanni Federico Torsello, Gabriela Equihua Martinez, Caroline Isner, Dirk SchĂźrmann, Frieder Pfäfflin, Arzu Orhun, Tommaso Manciulli &amp; Enrico Brunetti \" data-hash=\"12385\" data-license=\"CC BY 4.0\" data-source=\"https://link.springer.com/article/10.1007/s12328-021-01397-4\" data-tags=\"May2025\" height=\"442\" src=\"https://image.prepladder.com/notes/cmUVTiEsDKlnfPWCHJEg1746691424.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p>Active</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type III</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE3a</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Unilocular <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> with detached membranes and 'water-lily' sign.</p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CE3a\" data-author=\"Joachim Richter, Andreas Karl Lindner, Dominik Geisel, Giovanni Federico Torsello, Gabriela Equihua Martinez, Caroline Isner, Dirk SchĂźrmann, Frieder Pfäfflin, Arzu Orhun, Tommaso Manciulli &amp; Enrico Brunetti \" data-hash=\"12386\" data-license=\"CC BY 4.0\" data-source=\"https://link.springer.com/article/10.1007/s12328-021-01397-4\" data-tags=\"May2025\" height=\"430\" src=\"https://image.prepladder.com/notes/IzlbD5J9J8y7TAUZpa3X1746691441.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p>Transitional</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type II</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE3b</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Cyst with daughter cysts in a solid matrix.</p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CE3b\" data-author=\"Joachim Richter, Andreas Karl Lindner, Dominik Geisel, Giovanni Federico Torsello, Gabriela Equihua Martinez, Caroline Isner, Dirk SchĂźrmann, Frieder Pfäfflin, Arzu Orhun, Tommaso Manciulli &amp; Enrico Brunetti \" data-hash=\"12387\" data-license=\"CC BY 4.0\" data-source=\"https://link.springer.com/article/10.1007/s12328-021-01397-4\" data-tags=\"May2025\" height=\"408\" src=\"https://image.prepladder.com/notes/fhslaJDVIMEBb63QfJZk1746691497.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p>Transitional</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type III</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE4</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Heterogeneous echogenicity, no daughter cysts indicating degeneration.</p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CE4 hydatid cyst\" data-author=\"Joachim Richter, Andreas Karl Lindner, Dominik Geisel, Giovanni Federico Torsello, Gabriela Equihua Martinez, Caroline Isner, Dirk SchĂźrmann, Frieder Pfäfflin, Arzu Orhun, Tommaso Manciulli &amp; Enrico Brunetti \" data-hash=\"12388\" data-license=\"CC BY 4.0\" data-source=\"https://link.springer.com/article/10.1007/s12328-021-01397-4\" data-tags=\"May2025\" height=\"444\" src=\"https://image.prepladder.com/notes/GPq4TalHse7XKtq3bPQB1746691519.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p>Inactive</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type IV</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>CE5</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Calcified cyst, indicating inactivity.</p>\n</td>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"CE5\" data-author=\"Joachim Richter, Andreas Karl Lindner, Dominik Geisel, Giovanni Federico Torsello, Gabriela Equihua Martinez, Caroline Isner, Dirk SchĂźrmann, Frieder Pfäfflin, Arzu Orhun, Tommaso Manciulli &amp; Enrico Brunetti \" data-hash=\"12389\" data-license=\"CC BY 4.0\" data-source=\"https://link.springer.com/article/10.1007/s12328-021-01397-4\" data-tags=\"May2025\" height=\"390\" src=\"https://image.prepladder.com/notes/SSowKrqbYk5vEBIpFmRJ1746691535.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"vertical-align:top\">\n<p>Inactive</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>Type V</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please identify the structure labelled 'X' in the given ultrasound image of the liver. â", "options": [{"label": "A", "text": "Portal vein", "correct": true}, {"label": "B", "text": "Hepatic artery", "correct": false}, {"label": "C", "text": "Hepatic vein", "correct": false}, {"label": "D", "text": "Inferior vena cava", "correct": false}], "correct_answer": "A. Portal vein", "question_images": ["https://image.prepladder.com/notes/iVVeqz31AHzSGMWABZNW1747997909.png"], "explanation_images": ["https://image.prepladder.com/notes/O94CrcX9ciTVq3NJTWqx1747997977.png", "https://image.prepladder.com/notes/UaOq1dPetYou1uFPI1kQ1747998016.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most probable diagnosis for a young woman taking oral contraceptives based on the provided scan?", "options": [{"label": "A", "text": "Hepatocellular carcinoma", "correct": false}, {"label": "B", "text": "Metastatic infiltrates", "correct": false}, {"label": "C", "text": "Hepatic adenoma", "correct": true}, {"label": "D", "text": "Hemangioma", "correct": false}], "correct_answer": "C. Hepatic adenoma", "question_images": ["https://image.prepladder.com/content/016GmOXFYS5HSUIKtqtj1695368367.png"], "explanation_images": ["https://image.prepladder.com/content/1x4T9SHTwtD4g2eHvbnJ1695368387.png", "https://image.prepladder.com/content/xNoartXFdpUe5MgXPj4g1695368382.png"], "explanation": "<p>Correct Option C: H\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Lesion</strong></p>\n</td>\n<td>\n<p><strong>Characteristic Findings on Radiological <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">Diagnostic</span> Modalities</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Hepatic cyst</p>\n</td>\n<td>\n<p>Sharply demarcated wall, water density, non- enhancing</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Hemangioma</p>\n</td>\n<td>\n<p>Peripheral <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> in of contrast over time \"Light Bulb Sign\" on T2 <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> (centripetal filling)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Focal <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> <span class=\"customMeta\" data-dictid=\"4c5d5ef6c31692777189820d4b320d\">hyperplasia</span> (FNH)</p>\n</td>\n<td>\n<p>Early <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> in the arterial phase with central <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> (scar) <span class=\"customMeta\" data-dictid=\"4da708f8ee169277720241f79d3c3a\">fibrolamellar</span> HCC.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Hepatic adenoma</p>\n</td>\n<td>\n<p>Variable, central changes due to <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> are often seen</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Metastasis</p>\n</td>\n<td>\n<p>Mostly multiple low <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> lesions, rim <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> without \"filling in\" (bull eye appearance on ultrasound)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Abscess</p>\n</td>\n<td>\n<p>Well-demarcated <span class=\"customMeta\" data-dictid=\"11309a56bc1692777189e89a8d3041\">hypodense</span> areas with <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> enhancement</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Hepatocellular <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">carcinoma</span> (HCC)</p>\n</td>\n<td>\n<p>Early arterial enhancement, fast washout, delayed <span class=\"customMeta\" data-dictid=\"5d6dfa73b316927772028f3cd60f7f\">fibrous</span> <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> enhancement</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the artery marked by arrow", "options": [{"label": "A", "text": "Superior mesenteric artery", "correct": true}, {"label": "B", "text": "Inferior mesenteric", "correct": false}, {"label": "C", "text": "Celiac artery", "correct": false}, {"label": "D", "text": "Intestinal artery", "correct": false}], "correct_answer": "A. Superior mesenteric artery", "question_images": ["https://image.prepladder.com/content/iKTr4ewfrSaQwm3EIYMw1691499323.png"], "explanation_images": [], "explanation": "<table>\n<thead>\n<tr>\n<th>Artery</th>\n<th>Level on CT (Vertebral Level)</th>\n<th>Origin</th>\n<th>Branches</th>\n<th>Structures Supplied</th>\n<th>Imaging Clues on CT</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>Celiac Trunk</td>\n<td>T12âL1 (mainly T12)</td>\n<td>Abdominal <span class=\"customMeta\" data-dictid=\"ce68eab48a1692777181c719b4344e\">aorta</span> (anterior)</td>\n<td>Left gastric, splenic, common hepatic</td>\n<td>Foregut: <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">esophagus</span> to 2nd part of duodenum, etc.</td>\n<td>Short trunk, âtripodâ/âtrifurcationâ appearance</td>\n</tr>\n<tr>\n<td>Superior Mesenteric</td>\n<td>L1</td>\n<td>Aorta (just below celiac)</td>\n<td>Inferior pancreaticoduodenal, jejunal, etc.</td>\n<td>Midgut: <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"280e59e9331692777186f3beac2c41\">duodenum</span> to <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> 2/3 transverse</td>\n<td>Long, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> vessel <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> to celiac, over <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> vein</td>\n</tr>\n<tr>\n<td>Inferior Mesenteric</td>\n<td>L3</td>\n<td>Aorta (anterior)</td>\n<td>Left colic, sigmoid, superior rectal</td>\n<td>Hindgut: <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> 1/3 <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> <span class=\"customMeta\" data-dictid=\"0fce15e71f1692777184feb9af5303\">colon</span> to upper rectum</td>\n<td>Small, anterior, near aortic bifurcation</td>\n</tr>\n<tr>\n<td>Renal Arteries</td>\n<td>L1âL2</td>\n<td>Lateral aspect of aorta</td>\n<td>Segmental arteries</td>\n<td>Kidneys, <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">adrenal</span> glands, ureters</td>\n<td>Course laterally; right passes <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> to IVC</td>\n</tr>\n<tr>\n<td>Gonadal Arteries</td>\n<td>L2</td>\n<td>Aorta (anterior/lateral)</td>\n<td>No major named branches</td>\n<td>Gonads (testes/ovaries)</td>\n<td>Thin, descending; rarely visible unless dilated</td>\n</tr>\n<tr>\n<td>Common <span class=\"customMeta\" data-dictid=\"837bfc230c16927771892ece07f94b\">Iliac</span> Arteries</td>\n<td>L4</td>\n<td>Aortic bifurcation</td>\n<td>Internal and external <span class=\"customMeta\" data-dictid=\"837bfc230c16927771892ece07f94b\">iliac</span> arteries</td>\n<td>Pelvis, lower limbs</td>\n<td> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 16 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Identify the marked blood vessel in this MR Angiogram.", "options": [{"label": "A", "text": "Superficial temporal artery", "correct": true}, {"label": "B", "text": "Basilar artery", "correct": false}, {"label": "C", "text": "Middle meningeal artery", "correct": false}, {"label": "D", "text": "Occipital artery", "correct": false}], "correct_answer": "A. Superficial temporal artery", "question_images": ["https://image.prepladder.com/content/3wWQSOzmwBkqHy6MWJyI1741855246.png"], "explanation_images": ["https://image.prepladder.com/content/QfxRevbHb32vLGuDGXEH1741855462.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">Resonance</span> <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (MRA)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>There are various types of MR angiograms based on different principles and can be classified into non-contrast and contrast enhanced methods.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Non-contrast MRA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Contrast enhanced (CE) MRA</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Time-of-flight (TOF) imaging: </strong></p>\n<ul>\n<li>It is the <strong>most prevalent method </strong>for Magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">Resonance</span> <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (MRA) in clinical practice.</li>\n</ul>\n<p><strong>Phase-contrast MRA:</strong></p>\n<ul>\n<li>It is more sensitive for <strong>identifying slow <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> </strong>and useful for <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> cerebral veins (MR <span class=\"customMeta\" data-dictid=\"8a7362882e1692777201ef793c3fd4\">venography</span> or MRV).</li>\n<li>Effective for detecting <strong>dural <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">thrombosis</span> </strong>and <strong>venous stenoses.</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>MRA combined with<strong> gadolinium-based contrast agents</strong> is called contrast-enhanced (CE) MRA.<br/>\n\t\t\t\t </li>\n<li>Excellent for quickly visualizing the <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> and vertebral arteries where a large field of view (FOV) is necessary.<br/>\n\t\t\t\t </li>\n<li>Reduces artifacts caused by turbulent or slow flow.<br/>\n\t\t\t\t </li>\n<li>Useful for assessing <strong>arteriovenous malformations </strong>(AVMs), <strong>aneurysms</strong>, and <strong>intracranial stenosis</strong>.</li>\n<li>Two types are:\n\t\t\t\t<ul>\n<li>Elliptical-centric</li>\n<li>Multiphase techniques</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"2564\" src=\"https://image.prepladder.com/content/QfxRevbHb32vLGuDGXEH1741855462.png\" width=\"4167\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 11 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 47-year-old woman with a history of chronic kidney disease (CKD) from diabetic nephropathy has been on hemodialysis for three years. She reports persistent back pain and changes in posture. An X-ray shows specific findings, shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Ankylosing spondylitis", "correct": false}, {"label": "B", "text": "Hyperparathyroidism", "correct": true}, {"label": "C", "text": "Osteoporosis", "correct": false}, {"label": "D", "text": "Osteoblastic metastases", "correct": false}], "correct_answer": "B. Hyperparathyroidism", "question_images": ["https://image.prepladder.com/notes/kSTmVMZ0bQKFTsNcnMzb1744053736.png"], "explanation_images": ["https://image.prepladder.com/notes/qjMYjAMEKQy0qRTSPC1Y1744053917.png", "https://image.prepladder.com/notes/oXp4Q3Tkb2KdxD1GLtBX1744054019.png", "https://image.prepladder.com/notes/uZeSVlIzcyHHZiyB5opx1744054107.png", "https://image.prepladder.com/notes/kSTmVMZ0bQKFTsNcnMzb1744053736.png", "https://image.prepladder.com/notes/0MsFMZszoGOYhH4guhjn1744054285.png", "https://image.prepladder.com/notes/BVCzIYge3t3c8gnX26Lk1744054440.png", "https://image.prepladder.com/notes/vNQAejhL5178UnRSecV71744054535.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological features of Hyperparathyroidism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Subperiosteal resorption</strong> usually starts in the middle <span class=\"customMeta\" data-dictid=\"e9451cd23d1692777195fe471f486e\">phalanx</span> of the index finger's <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> side, leading to a <span class=\"customMeta\" data-dictid=\"5725f054721692777184f74b5fa780\">concavity</span> of bone<strong> </strong><strong>(the earliest bone change). </strong></li>\n</ul>\n<p><img alt=\"X ray of hand showing Subperiosteal resorption\" data-author=\"Bennett, Jackson &amp; Suliburk, James &amp; MorĂłn, Fanny.\" data-hash=\"7984\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Subperiosteal-resorption-of-the-radial-aspect-of-the-middle-phalanges-of-the-second-and_fig1_339432582\" data-tags=\"April2025\" height=\"332\" src=\"https://image.prepladder.com/notes/qjMYjAMEKQy0qRTSPC1Y1744053917.png\" width=\"300\"/></p>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>The \"salt and pepper\" appearance, or pepper pot skull</strong> (lytic lesions in the skull). </li>\n</ul>\n<p><img alt=\" X ray showing salt and pepper appearance of the skull\" data-author=\"haitham alfalah\" data-hash=\"7985\" data-license=\"NA\" data-source=\"https://commons.wikimedia.org/wiki/File:Pepper_%26_Salt.JPG\" data-tags=\"April2025\" height=\"199\" src=\"https://image.prepladder.com/notes/oXp4Q3Tkb2KdxD1GLtBX1744054019.png\" width=\"300\"/></p>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Brown tumor or <span class=\"customMeta\" data-dictid=\"dc4ced4b86169277719422ad2689a5\">osteitis</span> fibrosa cystica:</strong> <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">Cystic</span> lesions resulting from excessive <span class=\"customMeta\" data-dictid=\"fc8c28347a16927771945680bd00be\">osteoclastic</span> <span class=\"customMeta\" data-dictid=\"797daba8ca1692777197dc9f8d3a4a\">resorption</span> appear as low-density, multiloculated cysts that can cause bone expansion, often accompanied by <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> and <span class=\"customMeta\" data-dictid=\"09e414c5a71692777188ef029aefe5\">granulation</span> tissue (more common in primary hyperparathyroidism).</li>\n</ul>\n<p><img alt=\"X-ray of the hands showing brown tumors in the long bones of the fingers\" data-author=\"Frank Gaillard \" data-hash=\"7986\" data-license=\"CC BY-SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Osteitis_fibrosa_cystica#/media/File:Brown_tumours_of_the_hands.jpg\" data-tags=\"April2025\" height=\"270\" src=\"https://image.prepladder.com/notes/uZeSVlIzcyHHZiyB5opx1744054107.png\" width=\"300\"/></p>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<ul>\n<li><strong>Rugger jersey spine:</strong> Characterized by <span class=\"customMeta\" data-dictid=\"1b5a7ceea716927771815e7283e571\">alternating</span> black and white striations, with sclerosed white end plates and black vertebral bodies; commonly seen in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"303281f8d5169277719437cf04ebaf\">osteodystrophy</span> (secondary hyperparathyroidism). </li>\n</ul>\n<p><img alt=\"X ray spine showing rugger jersey spine\" data-author=\"Arambewela, Maulee &amp; Liyanarachchi, Kamani &amp; Somasundaram, Noel &amp; Pallewatte, Aruna &amp; Punchihewa, Gamini. \" data-hash=\"7983\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/ray-spine-showing-rugger-jersey-spine_fig3_318615259\" data-tags=\"April2025\" height=\"419\" src=\"https://image.prepladder.com/notes/kSTmVMZ0bQKFTsNcnMzb1744053736.png\" width=\"300\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hjJFJZcilby97UCGN8w41746779248.mp3", "video": ""}, {"text": "A 62-year-old man with a history of heart failure and sensorineural hearing loss presents with worsening bone pain in his pelvis and lower back, fatigue, heaviness in his legs, tibial deformities, and occasional headaches. Laboratory tests show elevated alkaline phosphatase (ALP) levels. Which radiographic finding is least likely associated with his condition?", "options": [{"label": "A", "text": "Osteoporosis circumscripta", "correct": false}, {"label": "B", "text": "Tam O'Shanter sign", "correct": false}, {"label": "C", "text": "Candle flame sign", "correct": false}, {"label": "D", "text": "Champagne glass pelvis.", "correct": true}], "correct_answer": "D. Champagne glass pelvis.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/QWcanUsHenvm8Tb2e7MR1744345172.png", "https://image.prepladder.com/notes/rcCdenJr0qSmKxSVxeN51744345173.png", "https://image.prepladder.com/notes/aicQoxjuNu5tM6mDa4l91744345173.png", "https://image.prepladder.com/notes/BukaD55D78bLZk9vbxEj1744345174.png", "https://image.prepladder.com/notes/meVjj9vI7Cj2pAyjBYWj1744345174.png", "https://image.prepladder.com/notes/HINxBCs1qNmKfoi7swFE1744343442.png", "https://image.prepladder.com/notes/UK6xXJIAotlzWKuJEaOQ1744344661.png", "https://image.prepladder.com/notes/ooiUBfXAVbBpXZDQTJDU1744345175.png", "https://image.prepladder.com/notes/glzT97VioazXeA7b0GI21744345176.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:607px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Osteoporosis circumscripta </strong><strong>(Option A) </strong><strong>:</strong> A <span class=\"customMeta\" data-dictid=\"89aa50eac91692777184c8f668d2cf\">circumscribed</span> patch of <span class=\"customMeta\" data-dictid=\"4c8be6d6b716927771948551f98378\">osteoporosis</span> in the skull.</p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA138\" data-author=\"\" data-hash=\"9067\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"371\" src=\"https://image.prepladder.com/notes/rcCdenJr0qSmKxSVxeN51744345173.png\" width=\"300\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>The cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> appearance of the skull</strong> (due to sclerosis)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA139\" data-author=\"\" data-hash=\"9068\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/aicQoxjuNu5tM6mDa4l91744345173.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tam O'Shanter sign</strong>: The skull's expansion and flattened base create the appearance of the skull tilting over the <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> structures (due to the thickening of the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> bone).</p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA140\" data-author=\"\" data-hash=\"9069\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"266\" src=\"https://image.prepladder.com/notes/BukaD55D78bLZk9vbxEj1744345174.png\" width=\"300\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Blade of grass appearance or candle flame sign </strong><strong>(Option C)</strong><strong>:</strong> Flame-shaped <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> extending along the <span class=\"customMeta\" data-dictid=\"665018e7801692777198b82c6c9db8\">shaft</span> of the bone.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA141\" data-author=\"\" data-hash=\"9070\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"300\" src=\"https://image.prepladder.com/notes/meVjj9vI7Cj2pAyjBYWj1744345174.png\" width=\"300\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Picture frame vertebra:</strong></p>\n<p>The <span class=\"customMeta\" data-dictid=\"9c0b99fa0816927772010e947b4ef6\">vertebrae</span> appear enlarged and have a thickened <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> bone due to excessive <span class=\"customMeta\" data-dictid=\"f8406817f21692777183176660cf3d\">bone remodeling</span> and disorganized osteoblastic activity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"RA125\" data-author=\"\" data-hash=\"9052\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"523\" src=\"https://image.prepladder.com/notes/HINxBCs1qNmKfoi7swFE1744343442.png\" width=\"300\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ivory vertebra:</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA136\" data-author=\"\" data-hash=\"9065\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"321\" src=\"https://image.prepladder.com/notes/UK6xXJIAotlzWKuJEaOQ1744344661.png\" width=\"300\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lincoln sign or Black Beard sign: </strong>Increased <span class=\"customMeta\" data-dictid=\"c5a32dfd6e1692777197db92b6aea1\">radiotracer</span> <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> in the <span class=\"customMeta\" data-dictid=\"55c062d44f16927771919375042b03\">mandible</span> gives it a distinctive black beard appearance that signifies <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> bone <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> in Pagetâs disease.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA142\" data-author=\"\" data-hash=\"9071\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ooiUBfXAVbBpXZDQTJDU1744345175.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Banana fractures: </strong>Occur in a region of <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> bone.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA143\" data-author=\"\" data-hash=\"9072\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"354\" src=\"https://image.prepladder.com/notes/glzT97VioazXeA7b0GI21744345176.png\" width=\"300\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qAwLs43T16q08nxoPQnf1747582834.mp3", "video": ""}, {"text": "Match the following skull findings according to their respective conditions. S.No Finding Condition 1. a) Pagetâs Disease 2. b) Hyperparathyroidism 3. c) Sickle Cell Anemia 4. d) Multiple Myeloma 5. e) Langerhans Cell Histiocytosis", "options": [{"label": "A", "text": "1-b, 2-d, 3-a, 4-e, 5-c", "correct": true}, {"label": "B", "text": "1-c, 2-e, 3-b, 4-d, 5-a", "correct": false}, {"label": "C", "text": "1-e, 2-c, 3-d, 4-b, 5-a", "correct": false}, {"label": "D", "text": "1-a, 2-b, 3-e, 4-c, 5-d", "correct": false}], "correct_answer": "A. 1-b, 2-d, 3-a, 4-e, 5-c", "question_images": ["https://image.prepladder.com/notes/EajxklrFjMlertIoPipg1744347785.png", "https://image.prepladder.com/notes/v4oKizQBAMhtaLL6KoDi1744347782.png", "https://image.prepladder.com/notes/BukaD55D78bLZk9vbxEj1744345174.png", "https://image.prepladder.com/notes/TV9X0b3BLLg7mDknBQNn1744347783.png", "https://image.prepladder.com/notes/cSRaEDIYWnmitlEjQ5EF1744347786.png"], "explanation_images": ["https://image.prepladder.com/notes/EajxklrFjMlertIoPipg1744347785.png", "https://image.prepladder.com/notes/v4oKizQBAMhtaLL6KoDi1744347782.png", "https://image.prepladder.com/notes/BukaD55D78bLZk9vbxEj1744345174.png", "https://image.prepladder.com/notes/TV9X0b3BLLg7mDknBQNn1744347783.png", "https://image.prepladder.com/notes/cSRaEDIYWnmitlEjQ5EF1744347786.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Radiological findings of the skull in different conditions</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA1068\" data-author=\"\" data-hash=\"9101\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/EajxklrFjMlertIoPipg1744347785.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hyperparathyroidism:</strong></p>\n<ul>\n<li><strong>Salt and pepper appearance of the skull is </strong>due to <span class=\"customMeta\" data-dictid=\"d54da38aaa1692777191560f60c0f9\">lytic</span> lesions caused by <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> resorption.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA171\" data-author=\"\" data-hash=\"9099\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/v4oKizQBAMhtaLL6KoDi1744347782.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Multiple Myeloma:</strong></p>\n<ul>\n<li>Well-defined<strong> <span class=\"customMeta\" data-dictid=\"7134f7f8681692777196fa644c43bf\">Punched-out</span> lesions</strong> involving both the tables of the skull.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA140\" data-author=\"\" data-hash=\"9069\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/BukaD55D78bLZk9vbxEj1744345174.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pagetâs Disease:</strong></p>\n<ul>\n<li><strong>Cortical Expansion</strong></li>\n<li><strong>Osteoporosis circumscripta: </strong>Focal areas of osteolytic lesions</li>\n<li><strong>Tamâo Shanter Sign: </strong>Thickening of <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">Frontal</span> Bone.</li>\n<li><strong>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">Wool</span> Appearance</strong> of the Skull is also seen.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA172\" data-author=\"\" data-hash=\"9100\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/TV9X0b3BLLg7mDknBQNn1744347783.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Langerhans Cell Histiocytosis:</strong></p>\n<ul>\n<li><strong>Bevelled <span class=\"customMeta\" data-dictid=\"d54da38aaa1692777191560f60c0f9\">Lytic</span> Lesion: </strong>Well-defined <span class=\"customMeta\" data-dictid=\"d54da38aaa1692777191560f60c0f9\">lytic</span> <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> with <span class=\"customMeta\" data-dictid=\"934e9f88af169277719847f1a0728f\">sclerotic</span> margin.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA1069\" data-author=\"\" data-hash=\"9102\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/cSRaEDIYWnmitlEjQ5EF1744347786.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sickle Cell Anemia:</strong></p>\n<ul>\n<li><strong>Crew cut Appearance: </strong>Due to <span class=\"customMeta\" data-dictid=\"0ba1f7edfa1692777187ae6f51e603\">Extramedullary</span> Hematopoiesis.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HoVXmw9o1KHcWnu35YYN1747929256.mp3", "video": ""}, {"text": "A 5-year-old boy presents with short stature and disproportionate limb length. His parents mention he has a broad forehead and has been slower to walk than peers &amp;amp; genetic testing reveals mutation in FGFR3 gene. Based on this presentation, which of the following radiological findings is least likely associated with his condition?", "options": [{"label": "A", "text": "Bullet nose vertebrae", "correct": false}, {"label": "B", "text": "Tam o'shanter sign", "correct": true}, {"label": "C", "text": "Trident hand sign", "correct": false}, {"label": "D", "text": "Champagne glass pelvis", "correct": false}], "correct_answer": "B. Tam o'shanter sign", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/1BQBQ2MYqEjK1lxByxNk1744346474.png", "https://image.prepladder.com/notes/vBgbS8zwSbZEJXwOe8Uo1744364151.png", "https://image.prepladder.com/notes/o2pfruIld5tjTMjKuZDh1744364152.png", "https://image.prepladder.com/notes/gWNd9296WYIibtFjW8BA1744364153.png", "https://image.prepladder.com/notes/OrzkJ5pP3NraRQawuisw1744446661.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/7orju1T40hOfidpTsZ2N1746979177.mp3", "video": ""}, {"text": "A 28-year-old female presents to the emergency department with sudden pain in her right foot after playing soccer. She reports hearing a \"snap\" when she landed awkwardly while attempting to head the ball. On examination, swelling and tenderness are noted. An X-ray is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Aviator fracture", "correct": false}, {"label": "B", "text": "Jones fracture", "correct": true}, {"label": "C", "text": "Pseudo-jones fracture", "correct": false}, {"label": "D", "text": "Loverâs fracture", "correct": false}], "correct_answer": "B. Jones fracture", "question_images": ["https://image.prepladder.com/notes/i7eHCnfVIFV7nY3rrN1J1744363636.png"], "explanation_images": ["https://image.prepladder.com/notes/i7eHCnfVIFV7nY3rrN1J1744363636.png", "https://image.prepladder.com/notes/XR9ZW6bwq3CnxVznH5y71744363636.png", "https://image.prepladder.com/notes/DJqxhjxJDJfmKi5ClyFm1744363637.png", "https://image.prepladder.com/notes/Z7gd4VHE2Rht10Ioo1aH1744363637.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:655px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Jones fracture</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Site </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fracture of the <strong>base of the fifth <span class=\"customMeta\" data-dictid=\"b7f1b05b6d1692777192a18bc2396f\">metatarsal</span> (extra-articular fracture)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is caused by the pull exerted by the <span class=\"customMeta\" data-dictid=\"606c2acae5169277720052151cb04c\">tendon</span> of the <strong>peroneus brevis muscle </strong>inserted on it.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-ray </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA234\" data-author=\"\" data-hash=\"9264\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/i7eHCnfVIFV7nY3rrN1J1744363636.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/iSmFiaFVcg17ACg5p0D41746979369.mp3", "video": ""}, {"text": "Match the following fractures with their radiographs: 1. Bennettâs fracture a. 2. Rolandoâs fracture b. 3. Gamekeeper fracture c. 4. Boxerâs fracture d.", "options": [{"label": "A", "text": "1-d, 2-c, 3-a, 4-b", "correct": false}, {"label": "B", "text": "1-b, 2-d, 3-a, 4-c", "correct": true}, {"label": "C", "text": "1-c, 2-a, 3-b, 4-d", "correct": false}, {"label": "D", "text": "1-b, 2-a, 3-d, 4-c", "correct": false}], "correct_answer": "B. 1-b, 2-d, 3-a, 4-c", "question_images": ["https://image.prepladder.com/notes/BqKo7aB39yyUJ6cpNrxx1744362811.png", "https://image.prepladder.com/notes/KbyhFGf8KOIJR2Tp6vC01744362810.png", "https://image.prepladder.com/notes/TvFLjwt8toZiixVJxShD1744362811.png", "https://image.prepladder.com/notes/ysE1hyQLFVaa7qrrhw0X1744362810.png"], "explanation_images": ["https://image.prepladder.com/notes/KbyhFGf8KOIJR2Tp6vC01744362810.png", "https://image.prepladder.com/notes/ysE1hyQLFVaa7qrrhw0X1744362810.png", "https://image.prepladder.com/notes/eYRN9AhDZ3E857KWIKMz1744362968.png", "https://image.prepladder.com/notes/BqKo7aB39yyUJ6cpNrxx1744362811.png", "https://image.prepladder.com/notes/TvFLjwt8toZiixVJxShD1744362811.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:676px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Fracture </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>X-ray </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bennettâs fracture</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Oblique<strong> <span class=\"customMeta\" data-dictid=\"f953c828ea16927771909cb3a51e36\">intra-articular</span> </strong>fracture of the <strong>base of the first metacarpal</strong> with <span class=\"customMeta\" data-dictid=\"e53b153fb316927771996481a3e88f\">subluxation</span> of the metacarpal.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA220\" data-author=\"\" data-hash=\"9245\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/KbyhFGf8KOIJR2Tp6vC01744362810.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rolandoâs fracture</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <strong>complete <span class=\"customMeta\" data-dictid=\"cd001152fe16927771823275439a2d\">articular</span> <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> (âT' or 'Y' shaped) of the first metacarpal.</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA221\" data-author=\"\" data-hash=\"9246\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ysE1hyQLFVaa7qrrhw0X1744362810.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Skierâs thumb or Gamekeeperâs thumb </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A tear of the<strong> <span class=\"customMeta\" data-dictid=\"d7fd512e881692777201909450fd8c\">ulnar</span> <span class=\"customMeta\" data-dictid=\"4de12d1ef31692777184db1d11c6bd\">collateral</span> ligament</strong> in the <span class=\"customMeta\" data-dictid=\"d7e158e089169277719265674b2879\">metacarpophalangeal</span> joint.</li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"RA224\" data-author=\"\" data-hash=\"9249\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/eYRN9AhDZ3E857KWIKMz1744362968.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA222\" data-author=\"\" data-hash=\"9247\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/BqKo7aB39yyUJ6cpNrxx1744362811.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Boxerâs <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Fracture through the <strong>neck of the metacarpal</strong> (commonly the <strong>5th metacarpal</strong>).</li>\n<li><strong>Cause:</strong> Closed fist hits against a hard object</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA223\" data-author=\"\" data-hash=\"9248\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/TvFLjwt8toZiixVJxShD1744362811.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MIxJXdHPz8dMjB2rzbIN1747040160.mp3", "video": ""}, {"text": "A 25-year-old man presents with wrist pain and swelling following a fall while skiing and also reports difficulty moving his wrist. Based on the X-ray findings, what is the cause of his condition?", "options": [{"label": "A", "text": "Avascular necrosis of Scaphoid", "correct": false}, {"label": "B", "text": "Scaphoid waist fracture line", "correct": false}, {"label": "C", "text": "Radial styloid fracture leading to carpal instability", "correct": false}, {"label": "D", "text": "Scapholunate ligament tear", "correct": true}], "correct_answer": "D. Scapholunate ligament tear", "question_images": ["https://image.prepladder.com/notes/N8fIIOSehMxvuSNUqyfn1744362341.png"], "explanation_images": ["https://image.prepladder.com/notes/owLVmIyYJdFISHc4kfNt1744362341.png", "https://image.prepladder.com/notes/N8fIIOSehMxvuSNUqyfn1744362341.png", "https://image.prepladder.com/notes/19lRBrrD5UpurapNTYLC1744362342.png", "https://image.prepladder.com/notes/vwg8FStoS0mjQ7pzN9B21744362343.png", "https://image.prepladder.com/notes/xopDXlTCalxnwCl3lsHX1744362345.png", "https://image.prepladder.com/notes/im47vb5yaE7vw8t4vLpz1744361382.png", "https://image.prepladder.com/notes/UFKrLHi6GPMbYZRTnPUH1744362345.png", "https://image.prepladder.com/notes/ext9Zudhx5fqJkhLFFJV1744362346.png", "https://image.prepladder.com/notes/t49g8DS6D0KNglH2Y9Vs1744362347.png"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Scapholunate dislocation</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Scaphoid fracture</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p>This occurs when an injury disrupts the <strong>scapholunate ligament</strong>, leading to <span class=\"customMeta\" data-dictid=\"acb259200b16927771908888d1377c\">instability</span> between the <span class=\"customMeta\" data-dictid=\"4992469b3c169277719874a6808793\">scaphoid</span> and <span class=\"customMeta\" data-dictid=\"2c800b393f1692777191e260e94f78\">lunate</span> bones.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>It can occur in 3 sites.</p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">Distal</span> tubercle</p>\n<p><strong>⢠Waist (Common)</strong></p>\n<p>⢠<span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">Proximal</span> pole</p>\n<p><img alt=\"RA213\" data-author=\"\" data-hash=\"9238\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/owLVmIyYJdFISHc4kfNt1744362341.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Mechanism of injury</strong></p>\n</td>\n<td colspan=\"2\" rowspan=\"1\" style=\"vertical-align:top\">\n<p>⢠Fall on the dorsiďŹexed hand</p>\n<p>⢠Fall on outstretched hand </p>\n<p>⢠Secondary to radial-styloid fracture</p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Signs &amp; Radiological findings</strong></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>Terry Thomas sign</strong> (increased gap between the <span class=\"customMeta\" data-dictid=\"4992469b3c169277719874a6808793\">scaphoid</span> and <span class=\"customMeta\" data-dictid=\"2c800b393f1692777191e260e94f78\">lunate</span> bones)</p>\n<p> </p>\n<p><img alt=\"RA212\" data-author=\"\" data-hash=\"9237\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/N8fIIOSehMxvuSNUqyfn1744362341.png\"/></p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"169e1c9eb416927772006ea5a02252\">Tenderness</span> over <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> <span class=\"customMeta\" data-dictid=\"cf2e5db74f1692777198e270bb0ada\">snuff</span> box.</strong></p>\n<p>⢠A <strong>âHumpback signâ</strong> is observed in displaced fractures.</p>\n<p> </p>\n<p><img alt=\"RA214\" data-author=\"\" data-hash=\"9239\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/19lRBrrD5UpurapNTYLC1744362342.png\"/></p>\n<p><strong>Waistline <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> of <span class=\"customMeta\" data-dictid=\"4992469b3c169277719874a6808793\">scaphoid</span> (Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>Treatment</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠Early detection</strong>: <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">Surgical</span> repair with <strong>K-wire fixation</strong> is done</p>\n<p>⢠Chronic case (without arthritis): <strong>Ligament repair</strong> is preferred.</p>\n<p>⢠Chronic case (with arthritis): <strong>Proximal row carpectomy, four-corner <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> or radio <span class=\"customMeta\" data-dictid=\"0f835d1564169277719843d601edf2\">scapholunate</span> <span class=\"customMeta\" data-dictid=\"129c645fde1692777182cf1d3e1ecc\">arthrodesis</span> is preferred</strong>.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠<span class=\"customMeta\" data-dictid=\"3024d9916e16927771896f5b7159b6\">Immobilization</span> with <strong>Scaphoid cast or Bohler-Gauntlet <span class=\"customMeta\" data-dictid=\"4992469b3c169277719874a6808793\">scaphoid</span> cast</strong> for undisplaced fractures</p>\n<p><strong>⢠ORIF with Herbert's screw.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p>Complications</p>\n</td>\n<td style=\"vertical-align:top\">\n<p>⢠<span class=\"customMeta\" data-dictid=\"c8a21e01261692777183ccc5569251\">Carpal</span> instability</p>\n<p>⢠Increased risk of osteoarthritis.</p>\n</td>\n<td style=\"vertical-align:top\">\n<p><strong>⢠<span class=\"customMeta\" data-dictid=\"a44009963c1692777182feb479b12b\">Avascular</span> necrosis</strong> <strong>(Option A)</strong> is common in <strong>proximal pole </strong>fractures of the <span class=\"customMeta\" data-dictid=\"4992469b3c169277719874a6808793\">scaphoid</span> due to the <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> primarily supplying the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> pole.</p>\n<p> It may show a <strong>ground-glass appearance</strong>, <strong>increased bone density</strong>, and, occasionally, <strong>collapse and fragmentation</strong> on X-ray.</p>\n<p><img alt=\"RA215\" data-author=\"\" data-hash=\"9240\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/vwg8FStoS0mjQ7pzN9B21744362343.png\"/></p>\n<p><strong>⢠Non-union</strong></p>\n<p><img alt=\"RA216\" data-author=\"\" data-hash=\"9241\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/xopDXlTCalxnwCl3lsHX1744362345.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:626px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Isolated <span class=\"customMeta\" data-dictid=\"2c800b393f1692777191e260e94f78\">Lunate</span> Dislocation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Perilunate dislocation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Scapholunate dislocation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"2c800b393f1692777191e260e94f78\">lunate</span> bone alone is dislocated anteriorly, whereas the carpals are in position</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"2c800b393f1692777191e260e94f78\">lunate</span> bone is not disrupted, but the surrounding carpals are dislocated dorsally</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>There is a gap between the <span class=\"customMeta\" data-dictid=\"4992469b3c169277719874a6808793\">scaphoid</span> and <span class=\"customMeta\" data-dictid=\"2c800b393f1692777191e260e94f78\">Lunate</span> bones.</p>\n<p>(Terry Thomas sign)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA217\" data-author=\"\" data-hash=\"9242\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/UFKrLHi6GPMbYZRTnPUH1744362345.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA218\" data-author=\"\" data-hash=\"9243\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ext9Zudhx5fqJkhLFFJV1744362346.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA219\" data-author=\"\" data-hash=\"9244\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/t49g8DS6D0KNglH2Y9Vs1744362347.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xCDXVCaLf2G6oMwlSP3A1747040572.mp3", "video": ""}, {"text": "A 32-year-old woman presents with wrist pain and swelling after sustaining a fall on an outstretched hand. An X-ray is performed; what is the likely diagnosis based on the findings?", "options": [{"label": "A", "text": "Hutchinson fracture", "correct": false}, {"label": "B", "text": "Colles fracture", "correct": false}, {"label": "C", "text": "Smith fracture", "correct": false}, {"label": "D", "text": "Bartonâs fracture", "correct": true}], "correct_answer": "D. Bartonâs fracture", "question_images": ["https://image.prepladder.com/notes/N849r9DWLSK6Be7f63de1744361380.png"], "explanation_images": ["https://image.prepladder.com/notes/CkbPLi5N7tjCjs8NnijL1744361381.png", "https://image.prepladder.com/notes/ux0ohjq3mwMhabGZjgy51744361381.png", "https://image.prepladder.com/notes/5LmyVXGlRqzEIyXeS8nD1744361382.png", "https://image.prepladder.com/notes/im47vb5yaE7vw8t4vLpz1744361382.png", "https://image.prepladder.com/notes/rlUZXAMbTiHaQJJGrroI1744361383.png", "https://image.prepladder.com/notes/BuVgO3holL8mvoGEfK5J1744361383.png", "https://image.prepladder.com/notes/OU32AFOgIkHZhk5s7pce1744361384.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bartonâs fracture</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Site </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Distal radius</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of injury</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fall on an outstretched hand</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Displacement</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Volar Bartonâs fracture</strong>: <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">Anterior</span> <span class=\"customMeta\" data-dictid=\"5a50cd774d1692777186c56ec68eac\">displacement</span> of the <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> fragment.</li>\n<li><strong>Dorsal Bartonâs fracture</strong>: <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">Posterior</span> <span class=\"customMeta\" data-dictid=\"5a50cd774d1692777186c56ec68eac\">displacement</span> of the <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> fragment. <img alt=\"RA205\" data-author=\"\" data-hash=\"9220\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/CkbPLi5N7tjCjs8NnijL1744361381.png\"/></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Closed reduction</li>\n<li>Open Reduction and Internal <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">Fixation</span> (ORIF)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-ray</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA204\" data-author=\"\" data-hash=\"9219\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ux0ohjq3mwMhabGZjgy51744361381.png\"/><br/>\n<br/>\n\t\t\t </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/IxJllrCJWYjPqkgwUGIN1747040337.mp3", "video": ""}, {"text": "A 28-year-old man presents with severe neck pain and limited head movement after falling from a 13-foot building. Examination reveals tenderness and restricted motion in the cervical spine. Based on his radiological findings, what is the likely diagnosis?", "options": [{"label": "A", "text": "Chance fracture", "correct": false}, {"label": "B", "text": "Hangman's fracture", "correct": false}, {"label": "C", "text": "Clay shovellerâs fracture", "correct": false}, {"label": "D", "text": "Jefferson fracture", "correct": true}], "correct_answer": "D. Jefferson fracture", "question_images": ["https://image.prepladder.com/notes/PWQGpaT1OGrxQmFkjBtM1744360684.png"], "explanation_images": ["https://image.prepladder.com/notes/J7iz9qp9jM3njiOeBWsB1744360684.png", "https://image.prepladder.com/notes/pdGedxmYmxh3R59USkF71744360685.png", "https://image.prepladder.com/notes/hq1J8OIsKk2FL3MBLHIS1744360686.png", "https://image.prepladder.com/notes/AXu9obWpe9QkUvQEcn0t1744360687.png", "https://image.prepladder.com/notes/KWBfeIJxUUQWWIdqPj3E1744360688.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Q8kOu2Y7DyXLA1WAdwqh1747041606.mp3", "video": ""}, {"text": "A 17-year-old male presents with a 3-month history of persistent pain and swelling above the left ankle, with constant and worsening discomfort, especially during physical activity. On examination, there is tenderness and a palpable mass over the lateral aspect of the distal fibula. An X-ray shows characteristic findings depicted in the image. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Ewing's Sarcoma", "correct": false}, {"label": "B", "text": "Osteosarcoma", "correct": true}, {"label": "C", "text": "Osteoblastoma", "correct": false}, {"label": "D", "text": "Osteochondroma", "correct": false}], "correct_answer": "B. Osteosarcoma", "question_images": ["https://image.prepladder.com/notes/8pirl9wWP3OBjVpYUsPG1747144215.png"], "explanation_images": ["https://image.prepladder.com/notes/KktIDuY4QNCrs84Jp4TX1744348549.png", "https://image.prepladder.com/notes/VugJMwf3cWUt1cPDQeoE1744360485.png", "https://image.prepladder.com/notes/IDi7Lx8bDsPzvTgwrKz81744360485.png", "https://image.prepladder.com/notes/lGHhiu4UlcKutcpM1e0o1744360486.png", "https://image.prepladder.com/notes/wBV7JwNcmINBAsvlRwbn1744360487.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ICG5BDZ1wcFFZJ7RRzia1747372014.mp3", "video": ""}, {"text": "A 30-year-old patient presents with localized pain and swelling in the anterior tibia. X-ray findings reveal the characteristics shown in the image. Based on these imaging features, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Simple Bone Cyst", "correct": false}, {"label": "B", "text": "Giant Cell Tumor", "correct": false}, {"label": "C", "text": "Aneurysmal Bone Cyst", "correct": false}, {"label": "D", "text": "Adamantinoma", "correct": true}], "correct_answer": "D. Adamantinoma", "question_images": ["https://image.prepladder.com/notes/xUI7bAa6STzkBz1iclHn1748189471.png"], "explanation_images": ["https://image.prepladder.com/notes/9uDomumwWgY1TMs8jxCL1744360120.png", "https://image.prepladder.com/notes/5Q1nDyN3gc3kef6Bn5ec1744360120.png", "https://image.prepladder.com/notes/20xmiuQK1vvGyYJBKWEW1744360121.png", "https://image.prepladder.com/notes/qzsVGaQzSekuZkwKanVX1744359753.png", "https://image.prepladder.com/notes/6C2Ti0e9OA6Ba22lXDi91744359754.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Epiphysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metaphysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diaphysis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Chondroblastoma</strong>: Most common before puberty.</li>\n<li><strong>Osteoclastoma/GCT(Giant Cell Tumor): </strong>Most common after puberty.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chondrosarcoma</li>\n<li>Osteochondroma</li>\n<li>Bone Cyst</li>\n<li>Enchondroma</li>\n<li>Osteosarcoma</li>\n<li>Osteoclastoma</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ewingâs Tumor</li>\n<li>Lymphoma</li>\n<li>Multiple Myeloma</li>\n<li>Adamantinoma</li>\n<li>Osteoid Osteoma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">     <img alt=\"RA190\" data-author=\"\" data-hash=\"9190\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"700\" src=\"https://image.prepladder.com/notes/5Q1nDyN3gc3kef6Bn5ec1744360120.png\" width=\"700\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 10-year-old patient presents with symptoms suggestive of osteomyelitis. An MRI is performed, and the radiologist notes a finding indicative of acute osteomyelitis. Which of the following findings is considered pathognomonic for this condition?", "options": [{"label": "A", "text": "Penumbra sign", "correct": false}, {"label": "B", "text": "Bone marrow edema", "correct": true}, {"label": "C", "text": "Sequestrum", "correct": false}, {"label": "D", "text": "Involucrum", "correct": false}], "correct_answer": "B. Bone marrow edema", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/lS2KWb0q5tncm8GDOMa81744359893.png", "https://image.prepladder.com/notes/k3bvvRdm4tUWCBHHsSkf1744359895.png", "https://image.prepladder.com/notes/c9gldrwSKeF5NR80tIbL1744359755.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:642px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute Osteomyelitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subacute Osteomyelitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chronic Osteomyelitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Plain Radiograph</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Minimal findings</li>\n<li>Possible soft-tissue swelling</li>\n</ul>\n<p>(5-7 days to appear)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lucent/sclerotic lesions</li>\n<li>Periosteal reaction</li>\n<li>Soft-tissue swelling</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bone sclerosis</li>\n<li>Cortical thickening</li>\n<li>Sequestrum</li>\n<li>Cloaca</li>\n<li>Bone destruction</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Computed Tomography</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Not Useful</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cortical/marrow abnormalities</li>\n<li>Abscess</li>\n<li>Periosteal reaction</li>\n<li>Edema</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior to radiograph</p>\n<p>for showing:</p>\n<ul>\n<li><strong>Cloaca/sequestrum</strong></li>\n<li><strong>Periosteal new bone formation</strong></li>\n<li>Abscess</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Early bone</strong></p>\n<p><strong>marrow edema</strong></p>\n<p><strong>(low T1, high T2)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bone marrow/cortical changes</li>\n<li>Increased T2 in soft tissues</li>\n<li>Abscess formation;</li>\n<li>Post-gadolinium T1 outlines the <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> <span class=\"customMeta\" data-dictid=\"ddba4206eb169277718335596e86da\">cavity</span> clearly</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Enhanced resolution for Sequestra &amp; Cloaca</li>\n<li>Outline abscess/sinus tracts</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bone scintigraphy</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased uptake</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 10-year-old boy presents with mild left arm pain, which has worsened over the past few months, particularly after a recent fall while playing. There are no signs of infection or soft tissue involvement. An X-ray shows the findings depicted in the image. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Simple Bone Cyst", "correct": true}, {"label": "B", "text": "Aneurysmal Bone Cyst", "correct": false}, {"label": "C", "text": "Brodie Abscess", "correct": false}, {"label": "D", "text": "Sequestrum", "correct": false}], "correct_answer": "A. Simple Bone Cyst", "question_images": ["https://image.prepladder.com/notes/oAzYACszXKeFUEBH0trP1748190917.png"], "explanation_images": ["https://image.prepladder.com/notes/oAzYACszXKeFUEBH0trP1748190917.png", "https://image.prepladder.com/notes/6C2Ti0e9OA6Ba22lXDi91744359754.png", "https://image.prepladder.com/notes/c9gldrwSKeF5NR80tIbL1744359755.png", "https://image.prepladder.com/notes/qBszyDUXPtE63MnGlq6X1744359757.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Simple Bone <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">Cyst</span> (SBC)</strong></p>\n<p style=\"text-align:center\"><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Aneurysmal Bone <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">Cyst</span> (ABC)</strong></p>\n<p style=\"text-align:center\"><strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Solitary, <strong>unilocular</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Benign, expansile, <strong>multi-cystic</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fluid Content</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Serous or sero-sanguinous</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Blood-filled</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Age Group</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Children and adolescents</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Children and teenagers</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Locations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Proximal humerus, femur, tibia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metaphysis of long bones, spine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Usually asymptomatic; <span class=\"customMeta\" data-dictid=\"c0c247b89916927771948bc5e6d39c\">pathological</span> fracture</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pain and swelling; possible neurological symptoms</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Well-defined, <span class=\"customMeta\" data-dictid=\"d54da38aaa1692777191560f60c0f9\">lytic</span> lesions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Poorly defined, eroding lesions</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-ray</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA183\" data-author=\"\" data-hash=\"9178\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"439\" src=\"https://image.prepladder.com/notes/6C2Ti0e9OA6Ba22lXDi91744359754.png\" width=\"300\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QWxrCiuNvxe7wYUA8pdK1747936249.mp3", "video": ""}, {"text": "A 30-year-old male presents with pain in the thigh and a noticeable deformity, as shown in the image. This deformity can be seen in all the following conditions except?", "options": [{"label": "A", "text": "Paget's disease of bone", "correct": false}, {"label": "B", "text": "Osteogenesis imperfecta", "correct": false}, {"label": "C", "text": "Osteopetrosis", "correct": true}, {"label": "D", "text": "Fibrous dysplasia", "correct": false}], "correct_answer": "C. Osteopetrosis", "question_images": ["https://image.prepladder.com/notes/W2qoviHsVBL3Al4sqkqg1748190393.png"], "explanation_images": ["https://image.prepladder.com/notes/W2qoviHsVBL3Al4sqkqg1748190393.png", "https://image.prepladder.com/notes/TuHaXC9vr9XpQTriTdaN1744348930.png", "https://image.prepladder.com/notes/OFnf4jtHZd9DObkVrrF91744348931.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which angle is typically used to measure the degree of spinal curvature?", "options": [{"label": "A", "text": "Codman angle", "correct": false}, {"label": "B", "text": "Ferguson angle", "correct": false}, {"label": "C", "text": "Cobb angle", "correct": true}, {"label": "D", "text": "Q-angle", "correct": false}], "correct_answer": "C. Cobb angle", "question_images": ["https://image.prepladder.com/notes/XAoVSxBXDtvXGlhFHXys1744348547.png"], "explanation_images": ["https://image.prepladder.com/notes/x3dfEMHb6RYkqI2kThii1744348548.png", "https://image.prepladder.com/notes/KktIDuY4QNCrs84Jp4TX1744348549.png", "https://image.prepladder.com/notes/lyRIr0dX4t8jdniY1Rgl1744348550.png", "https://image.prepladder.com/notes/SllAEzq75BebBCAYmBiV1744348550.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GGkvn32uxEm7cN76AqTr1747935726.mp3", "video": ""}, {"text": "A 24-year-old male presents with persistent nocturnal pain in his right femur that is relieved by nonsteroidal anti-inflammatory drugs (NSAIDs). On examination, there is localised tenderness in the area &amp;amp; no history of trauma. The radiographic evaluation shows a small, well-defined lytic lesion with a central nidus. What is the investigation of choice to confirm the diagnosis?", "options": [{"label": "A", "text": "X-ray of the femur", "correct": false}, {"label": "B", "text": "MRI of the femur", "correct": false}, {"label": "C", "text": "DEXA scan", "correct": false}, {"label": "D", "text": "CT scan of the femur", "correct": true}], "correct_answer": "D. CT scan of the femur", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/o01CC98WsXTJP0aQvoOA1744051967.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wr9nmQmgZDh2hT8tulXh1746778941.mp3", "video": ""}, {"text": "A 45-year-old woman presents with a 3-month history of bilateral wrist and knee pain, worse with inactivity and improving with movement. She reports morning stiffness lasting over an hour, fatigue, and low-grade fever. On examination, hand deformities are noted. All of the following are associated with her condition except:", "options": [{"label": "A", "text": "Hitchhiker's thumb deformity", "correct": false}, {"label": "B", "text": "Boutonniere deformity", "correct": false}, {"label": "C", "text": "Swan neck deformity", "correct": false}, {"label": "D", "text": "Calcinosis cutis", "correct": true}], "correct_answer": "D. Calcinosis cutis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ZSEjK4gcfg9n3H5vQNuB1744347385.png", "https://image.prepladder.com/notes/07oW5FpUSw8UCQE8fo6k1744347386.png", "https://image.prepladder.com/notes/2sXKMATr9aHublfK87qL1744347388.png", "https://image.prepladder.com/notes/djamKgAMqarEjtXVTDBY1744347389.png", "https://image.prepladder.com/notes/RbS8g6JuweRD4ek3kUp21744347389.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:558px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs &amp; radiological findings of <span class=\"customMeta\" data-dictid=\"40dbde72e41692777197e59d893839\">Rheumatoid</span> arthritis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>MCP jointâs subluxation</strong><strong> </strong> <img alt=\"RA166\" data-author=\"\" data-hash=\"9094\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ZSEjK4gcfg9n3H5vQNuB1744347385.png\"/></li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Ball catcher's or Norgaard's view</strong> is used to evaluate the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"e9451cd23d1692777195fe471f486e\">phalanx</span> erosions.<img alt=\"RA167\" data-author=\"\" data-hash=\"9095\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/07oW5FpUSw8UCQE8fo6k1744347386.png\"/></li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Hammer toe</strong> (due to extended DIP and flexed <span class=\"customMeta\" data-dictid=\"bc2c34fe2216927771957ca73ba3d9\">PIP</span> of the toe)  <img alt=\"RA168\" data-author=\"\" data-hash=\"9096\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/2sXKMATr9aHublfK87qL1744347388.png\"/></li>\n</ul>\n<p> </p>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Hitchhiker's thumb</strong> (caused by extended IP and flexed <span class=\"customMeta\" data-dictid=\"c208204e741692777192d05da0b9cd\">MCP</span> of thumb)<img alt=\"RA169\" data-author=\"\" data-hash=\"9097\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/djamKgAMqarEjtXVTDBY1744347389.png\"/></li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Ulnar <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> of MCP</strong></li>\n<li><strong>Swan neck deformity</strong> (caused by extended DIP and flexed PIP)</li>\n<li><strong>Boutonniere deformity</strong> (due to flexed <span class=\"customMeta\" data-dictid=\"bc2c34fe2216927771957ca73ba3d9\">PIP</span> and extended DIP <img alt=\"RA170\" data-author=\"\" data-hash=\"9098\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/RbS8g6JuweRD4ek3kUp21744347389.png\"/></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PHP3vIVh2fResGYWzewE1747589581.mp3", "video": ""}, {"text": "Match the following X-rays with their corresponding diagnoses X-rays Diagnosis 1. A. Achondroplasia 2. B. Tuberculosis 3. C. Acromegaly 4. D. Crest Syndrome 5. E. Psoriatic Arthritis", "options": [{"label": "A", "text": "1-B, 2-A, 3-D, 4-E, 5-C", "correct": false}, {"label": "B", "text": "1-E, 2-C, 3-B, 4-A, 5-D", "correct": false}, {"label": "C", "text": "1-D, 2-B, 3-E, 4-C, 5-A", "correct": false}, {"label": "D", "text": "1-C, 2-A, 3-E, 4-B, 5-D", "correct": true}], "correct_answer": "D. 1-C, 2-A, 3-E, 4-B, 5-D", "question_images": ["https://image.prepladder.com/content/zaXQusDXE85w7atm8EYu1741231854.png", "https://image.prepladder.com/content/VwecJh6Lo90zYmhjkUfO1741231878.png", "https://image.prepladder.com/content/MAnloo1yrU66lXK2NNLq1741231902.png", "https://image.prepladder.com/content/08eKALkq8lxrfwVdRS4C1741231923.png", "https://image.prepladder.com/content/tiVUQoucMt5Y1mjwYu4f1741231949.png"], "explanation_images": ["https://image.prepladder.com/notes/kn2Mzd0bLOzQQ5dF6IZo1744346473.png", "https://image.prepladder.com/notes/1BQBQ2MYqEjK1lxByxNk1744346474.png", "https://image.prepladder.com/notes/5dR4syxvrw9cCUOwGAlc1744346753.png", "https://image.prepladder.com/notes/nSGEI88gcKg1473mzXs41744346753.png", "https://image.prepladder.com/notes/VJYrPmG5mlx7fQ04Cup21744346754.png", "https://image.prepladder.com/notes/dNgG3DOBZYPkdPH0Wc221744346754.png", "https://image.prepladder.com/notes/zAhsfTLXrUipxj6zIqDM1744346757.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:675px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"RA159\" data-author=\"\" data-hash=\"9087\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/kn2Mzd0bLOzQQ5dF6IZo1744346473.png\"/><strong>Spade phalanx</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acromegaly/ Gigantism</strong></p>\n<ul>\n<li><strong>X-ray findings include</strong>\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"e9451cd23d1692777195fe471f486e\">phalanx</span> is spade-shaped</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"0f66ada5d616927771898f530a8510\">heel pad</span> thickness</li>\n<li>Wide joint spaces.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><img alt=\"RA160\" data-author=\"\" data-hash=\"9088\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/1BQBQ2MYqEjK1lxByxNk1744346474.png\"/><strong>Trident Hand sign</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Achondroplasia</strong></p>\n<ul>\n<li><strong>X-ray findings:</strong>\n<ul>\n<li><strong>Trident hand sign</strong></li>\n<li><strong>Pelvic champagne glass appearance </strong></li>\n<li><strong>Tombstone appearance of the <span class=\"customMeta\" data-dictid=\"837bfc230c16927771892ece07f94b\">iliac</span> blade</strong></li>\n<li><strong>Bullet nose vertebrae</strong></li>\n<li><strong>Chevron sign </strong><img alt=\"RA161\" data-author=\"\" data-hash=\"9089\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/5dR4syxvrw9cCUOwGAlc1744346753.png\"/><img alt=\"RA162\" data-author=\"\" data-hash=\"9090\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/nSGEI88gcKg1473mzXs41744346753.png\"/></li>\n</ul>\n</li>\n</ul>\n<br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><img alt=\"RA163\" data-author=\"\" data-hash=\"9091\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/VJYrPmG5mlx7fQ04Cup21744346754.png\"/><strong>Arthritis Mutilans</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Psoriatic Arthritis</strong></p>\n<ul>\n<li>Extensive <span class=\"customMeta\" data-dictid=\"68186a21531692777194663901ae59\">osteolysis</span> of the <span class=\"customMeta\" data-dictid=\"65604d11831692777190c5ea442405\">Interphalangeal</span> joints causing <strong>Arthritis Mutilans or opera glass hand <span class=\"customMeta\" data-dictid=\"ce2b48d83d1692777185427cee6c98\">deformity</span> </strong>and pencil-in cup deformity</li>\n<li>Telescoping fingers and sausage digits can be seen.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><img alt=\"RA164\" data-author=\"\" data-hash=\"9092\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/dNgG3DOBZYPkdPH0Wc221744346754.png\"/><strong>TB dactylitis</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tuberculosis of Phalanx</strong></p>\n<ul>\n<li>It shows <span class=\"customMeta\" data-dictid=\"78d32c50611692777199c6c6b9b525\">Spina</span> Ventosa or TB dactylitis, caused by the destruction of bone by a cyst-like cavity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><img alt=\"RA165\" data-author=\"\" data-hash=\"9093\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/zAhsfTLXrUipxj6zIqDM1744346757.png\"/><strong>Calcinosis Cutis</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CREST Syndrome</strong></p>\n<ul>\n<li>It is caused by the <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> deposition of <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> salts in the skin and <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">subcutaneous</span> tissues.</li>\n<li>Common in<strong> Scleroderma</strong> (Autoimmune condition)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qr9r1bxzWKiHLDT54Jcl1747589370.mp3", "video": ""}, {"text": "A 52-year-old man presents with chronic joint pain, stiffness, and mottling of teeth. He has a history of living in a rural area for several decades. His X-ray reveals increased bone density and calcification of ligaments. Based on these findings, which condition is most likely responsible for his symptoms?", "options": [{"label": "A", "text": "Accumulation of Homogentisic acid", "correct": false}, {"label": "B", "text": "Accumulation of Mucopolysaccharides", "correct": false}, {"label": "C", "text": "Excessive accumulation of Iron", "correct": false}, {"label": "D", "text": "Increased fluoride intake", "correct": true}], "correct_answer": "D. Increased fluoride intake", "question_images": ["https://image.prepladder.com/notes/RK7s1nCO67sQeJYJXuEM1744346464.png", "https://image.prepladder.com/notes/PoLKmTTLQbmBojshnZaw1744346466.png"], "explanation_images": ["https://image.prepladder.com/notes/RK7s1nCO67sQeJYJXuEM1744346464.png", "https://image.prepladder.com/notes/PoLKmTTLQbmBojshnZaw1744346466.png", "https://image.prepladder.com/notes/R6F91BscfqQa30vNlhbz1744346467.png", "https://image.prepladder.com/notes/BKwdyKejIJEAL5I65z561744346469.png", "https://image.prepladder.com/notes/kTI1WJo0lclp9gh1CwRY1744346470.png", "https://image.prepladder.com/notes/CbmrXOKztvybXQrOMJu71744346471.png", "https://image.prepladder.com/notes/lRME1FpAAS2vgKZexysX1744346473.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:383px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fluorosis <span class=\"customMeta\" data-dictid=\"fd0c8ab494169277720227102dc79a\">X-ray</span> findings</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increased bone density</li>\n<li>Cortical thickening</li>\n<li>Osteosclerosis</li>\n<li>Calcification of ligaments</li>\n<li>Subperiosteal bone formation</li>\n<li>Interosseous <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> calcification</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/eF4i3tObvjIdW9zBXXQA1747584091.mp3", "video": ""}, {"text": "\"Scotty dog\" sign is seen in?", "options": [{"label": "A", "text": "Normal vertebral findings", "correct": true}, {"label": "B", "text": "Spondylolisthesis", "correct": false}, {"label": "C", "text": "Osteoporosis", "correct": false}, {"label": "D", "text": "Spondylolysis", "correct": false}], "correct_answer": "A. Normal vertebral findings", "question_images": ["https://image.prepladder.com/notes/gaQEztuzYHvVdpKOghQE1744345678.png"], "explanation_images": ["https://image.prepladder.com/notes/JDoQv8ksgg3Z78lL2rUc1744345680.png", "https://image.prepladder.com/notes/Z8QxvzcobQyEsHBM8XPa1744345681.png", "https://image.prepladder.com/notes/H01qkpGdrAsB0Pii6dPI1744345681.png", "https://image.prepladder.com/notes/ZH4a9CZpck430UmKBr6U1744343812.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vJgUMvoErDKCM4gfoLMe1747583849.mp3", "video": ""}, {"text": "A 15-year-old boy, notably taller than his peers, presents with lower back pain and has a history of frequent shoulder dislocations. Scoliosis is noted, and an MRI has been recommended for further evaluation. Which of the following conditions aligns with the given radiological finding?", "options": [{"label": "A", "text": "Aortic aneurysm", "correct": false}, {"label": "B", "text": "Retroperitoneal lymphadenopathy", "correct": false}, {"label": "C", "text": "Downâs syndrome", "correct": false}, {"label": "D", "text": "Marfan syndrome", "correct": true}], "correct_answer": "D. Marfan syndrome", "question_images": ["https://image.prepladder.com/notes/84agyTip7zHY7hCbd99c1744345471.png"], "explanation_images": ["https://image.prepladder.com/notes/84agyTip7zHY7hCbd99c1744345471.png", "https://image.prepladder.com/notes/e5rnP6Ml5OStBEqC9W4Y1744345471.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posterior scalloping </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anterior scalloping </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Neural Tumors and cysts\n\t\t\t\t<ul>\n<li>Schwannoma</li>\n<li>Neurofibroma</li>\n<li>Lipoma</li>\n<li>Astrocytoma</li>\n</ul>\n</li>\n<li>Acromegaly</li>\n<li>Achondroplasia</li>\n<li>Loeys-Dietz syndrome</li>\n<li>Marfan syndrome</li>\n<li>Mucopolysaccharidosis</li>\n<li>Osteogenesis imperfecta</li>\n<li>Neurofibromatosis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Retroperitoneal lymphadenopathy<strong> </strong><strong>(Option B)</strong></li>\n<li>Abdominal aortic <span class=\"customMeta\" data-dictid=\"f2c92eaffe16927771819978aa5666\">aneurysm</span> <strong>(Option A)</strong></li>\n<li>Down syndrome <strong>(Option C)</strong></li>\n</ul>\n<br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><img alt=\"RA146\" data-author=\"\" data-hash=\"9074\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"397\" src=\"https://image.prepladder.com/notes/84agyTip7zHY7hCbd99c1744345471.png\" width=\"300\"/></td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><img alt=\"RA147\" data-author=\"\" data-hash=\"9075\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"423\" src=\"https://image.prepladder.com/notes/e5rnP6Ml5OStBEqC9W4Y1744345471.png\" width=\"300\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tQVFSdHN49SZY0oAOK6e1747583611.mp3", "video": ""}, {"text": "What is the most likely T-score that would confirm the diagnosis of osteoporosis?", "options": [{"label": "A", "text": "&amp;gt;-1.0", "correct": false}, {"label": "B", "text": "-1.0 to -2.5", "correct": false}, {"label": "C", "text": "&amp;lt;-2.5", "correct": true}, {"label": "D", "text": "&amp;lt;-2.5 with fracture", "correct": false}], "correct_answer": "C. &lt;-2.5", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/dHoJjLh6n3Bqqeku2Hhe1744345335.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:525px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>WHO Criteria for <span class=\"customMeta\" data-dictid=\"4c8be6d6b716927771948551f98378\">Osteoporosis</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T score</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Interpretation </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;-1.0 <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal BMD (bone mineral density)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-1.0 to -2.5 <strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Osteopenia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&lt;-2.5 <strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Osteoporosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&lt;-2.5 with <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe osteoporosis</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JYcKls5TJVSwNdxPM1Yu1747583072.mp3", "video": ""}, {"text": "Match the following radiological findings with their associated condition. Radiological finding Condition 1. a) Paget's disease 2. b) Vertebral hemangioma 3. c) Osteopetrosis 4. d) Ankylosing spondylitis", "options": [{"label": "A", "text": "1-c, 2-d, 3-b, 4-a", "correct": true}, {"label": "B", "text": "1-c, 2-b, 3-a, 4-d", "correct": false}, {"label": "C", "text": "1-d, 2-c, 3-a, 4-b", "correct": false}, {"label": "D", "text": "1-b, 2-c, 3-d, 4-a", "correct": false}], "correct_answer": "A. 1-c, 2-d, 3-b, 4-a", "question_images": ["https://image.prepladder.com/notes/NDlnFTMzYI0tjgUgRa7m1746984881.png", "https://image.prepladder.com/notes/nSWxDADm2raV3Skmc4Zu1746984939.png", "https://image.prepladder.com/notes/tWTDtzWBCXc7cbER5ruB1744344660.png", "https://image.prepladder.com/notes/UK6xXJIAotlzWKuJEaOQ1744344661.png"], "explanation_images": ["https://image.prepladder.com/notes/NDlnFTMzYI0tjgUgRa7m1746984881.png", "https://image.prepladder.com/notes/nSWxDADm2raV3Skmc4Zu1746984939.png", "https://image.prepladder.com/notes/tWTDtzWBCXc7cbER5ruB1744344660.png", "https://image.prepladder.com/notes/UK6xXJIAotlzWKuJEaOQ1744344661.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:682px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vertebral appearances</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Seen in </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological image</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bone within bone appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Osteopetrosis </strong></p>\n<p>(Marble bone disease)</p>\n<ul>\n<li>Bone within bone appearance</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Osteopetrosis\" data-author=\"\" data-hash=\"12463\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/NDlnFTMzYI0tjgUgRa7m1746984881.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intervertebral Disc Calcification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ochronosis alkaptonuria</li>\n<li><strong>Ankylosing spondylitis</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Ankylosing spondylitis\" data-author=\"\" data-hash=\"12464\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/nSWxDADm2raV3Skmc4Zu1746984939.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Polka Dot Appearance and Corduroy/Jail BarAppearance:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vertebral hemangioma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA135\" data-author=\"\" data-hash=\"9064\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/tWTDtzWBCXc7cbER5ruB1744344660.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ivory Vertebrae</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Paget's disease</strong></li>\n<li>Lymphoma</li>\n<li>Osteoblastic metastasis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA136\" data-author=\"\" data-hash=\"9065\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/UK6xXJIAotlzWKuJEaOQ1744344661.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/UOr6hqVg37LbXwofEFyH1747582601.mp3", "video": ""}, {"text": "A 16-year-old girl with sickle cell anemia was diagnosed at birth. She recently went to the hospital due to severe back pain that worsens with activity, as well as numbness and tingling in her legs, difficulty walking, and occasional weakness in her lower extremities. Which option accurately represents the radiographic findings of her spine for her condition?", "options": [{"label": "A", "text": "No options available", "correct": false}], "correct_answer": "Unknown", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/0T8ATUX9QLaedZFWpxC21744343441.png", "https://image.prepladder.com/notes/J76Jd3yisK8ZeARaoQxW1744343443.png", "https://image.prepladder.com/notes/SESYoty7BcoMMltU06GU1744343681.png", "https://image.prepladder.com/notes/HINxBCs1qNmKfoi7swFE1744343442.png", "https://image.prepladder.com/notes/0T8ATUX9QLaedZFWpxC21744343441.png", "https://image.prepladder.com/content/SoCSEDKtdAmdGQqehCHY1741227924.png", "https://image.prepladder.com/notes/uV1q86dXcVgvZyf1YWnT1744343442.png", "https://image.prepladder.com/notes/CfJ0lzPqKfJCOm5aUChu1744343862.png", "https://image.prepladder.com/notes/v186nqBZgvDRGlm1qNen1744343444.png", "https://image.prepladder.com/notes/9uAu56mnJOtNgmH2g4zz1744343963.png", "https://image.prepladder.com/notes/AMYkuwEZEk3kWwLxLqvv1744343964.png", "https://image.prepladder.com/notes/0T8ATUX9QLaedZFWpxC21744343441.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:682px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vertebral appearances</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Seen in </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological image</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rugger Jersey Spine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Renal osteodystrophy</p>\n<p>(Secondary hyperparathyroidism)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA117\" data-author=\"\" data-hash=\"9057\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/SESYoty7BcoMMltU06GU1744343681.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Picture frame vertebra</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pagetâs disease</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA125\" data-author=\"\" data-hash=\"9052\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/HINxBCs1qNmKfoi7swFE1744343442.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>H-shaped appearance or Lincoln Log Vertebrae</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sickle cell anemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA124\" data-author=\"\" data-hash=\"9051\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/0T8ATUX9QLaedZFWpxC21744343441.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Biconcave <span class=\"customMeta\" data-dictid=\"9c0b99fa0816927772010e947b4ef6\">Vertebrae</span> (or) Codfish <span class=\"customMeta\" data-dictid=\"9c0b99fa0816927772010e947b4ef6\">Vertebrae</span> (or) Fish Mouth Vertebrae</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Osteoporosis</li>\n<li>Osteomalacia</li>\n<li>Sickle cell <span class=\"customMeta\" data-dictid=\"53bee2a41216927771814d7ec3a67f\">anemia</span> (later stages)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"277\" src=\"https://image.prepladder.com/content/SoCSEDKtdAmdGQqehCHY1741227924.png\" width=\"286\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vertebrae Plana</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Trauma (most common cause in adults)</li>\n<li>Eosinophilic <span class=\"customMeta\" data-dictid=\"2334b7498b1692777188fa8b2eee36\">granuloma</span> (Langerhans cell histiocytosis)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA126\" data-author=\"\" data-hash=\"9053\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uV1q86dXcVgvZyf1YWnT1744343442.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Beaking of the Vertebrae</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mucopolysaccharidosis (MPS)</li>\n<li><strong>Hurler's syndrome (anterior beaking or bullet-shaped vertebrae) </strong><strong> </strong><strong>(Option B)</strong></li>\n<li>Hunter's syndrome</li>\n<li>Morquio's syndrome (middle beaking)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA1073\" data-author=\"\" data-hash=\"9059\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/CfJ0lzPqKfJCOm5aUChu1744343862.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vertebral Scalloping</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Posterior scalloping is seen in:</strong>\n<ul>\n<li>Dural <span class=\"customMeta\" data-dictid=\"def85be6371692777186604c253b12\">ectasia</span> (Marfan's syndrome or Neurofibromatosis)</li>\n<li>Neurogenic tumors (e.g., schwannoma)</li>\n</ul>\n</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Anterior scalloping seen in:</strong>\n<ul>\n<li>Aortic aneurysm.</li>\n<li>Lymphadenopathy of <span class=\"customMeta\" data-dictid=\"5d0f37715816927771973ecda21336\">retroperitoneal</span> and paraaortic <span class=\"customMeta\" data-dictid=\"4df97a6cbf169277719172fd1af767\">lymph</span> nodes (Tuberculosis)</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA129\" data-author=\"\" data-hash=\"9056\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/v186nqBZgvDRGlm1qNen1744343444.png\"/></td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:649px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Features of Sickle Cell Anaemia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Images </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hair on-end (or crew cut) appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA131\" data-author=\"\" data-hash=\"9060\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/9uAu56mnJOtNgmH2g4zz1744343963.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bone infarcts</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA132\" data-author=\"\" data-hash=\"9061\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/AMYkuwEZEk3kWwLxLqvv1744343964.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>H-shaped or Lincoln Log Vertebrae:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA124\" data-author=\"\" data-hash=\"9051\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/0T8ATUX9QLaedZFWpxC21744343441.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5RUpIHBM3lCUh7vn2Ygc1746779468.mp3", "video": ""}, {"text": "A 3-year-old child presents with fatigue, swollen and bleeding gums, bruising, joint pain, and dry skin. After a dietary assessment, it is found that the child has been consuming a diet low in fruits and vegetables. Which radiographic feature is most indicative of the probable condition?", "options": [{"label": "A", "text": "Widening of the growth plate", "correct": false}, {"label": "B", "text": "Cupping of the metaphysis", "correct": false}, {"label": "C", "text": "Wimbergerâs ring in the epiphysis", "correct": true}, {"label": "D", "text": "Absence of white line of Frankel", "correct": false}], "correct_answer": "C. Wimbergerâs ring in the epiphysis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/DECXKs75Q3sRIPg4l0zI1744052381.png", "https://image.prepladder.com/notes/uvdbBqvkEqDW6DYBYjso1744343111.png", "https://image.prepladder.com/notes/iVMHaOyg43mSG1fBowU01744343113.png", "https://image.prepladder.com/notes/XXnoEJ0bsYPbMCZWFnmL1744343113.png", "https://image.prepladder.com/notes/xKqfzA5QF2q6wOn4BcI61744343114.png", "https://image.prepladder.com/notes/C155CfCov6Ib0duFQvZx1744343115.png", "https://image.prepladder.com/notes/vKrd27vhGoIWsZefMXHq1744343208.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:664px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Scurvy </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rickets </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Deficient vitamin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vitamin C</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vitamin D</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reduced levels of</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Collagen</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Calcium</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Clinical features</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> fragility</li>\n<li>Appearance of <span class=\"customMeta\" data-dictid=\"8fad605541169277719552afc9ebac\">petechiae</span> on the skin</li>\n<li>Delayed wound healing</li>\n<li>Bleeding gums</li>\n</ul>\n<img alt=\"Bleeding gums\" data-author=\"Patrick T. LiuJ. KujakC. RobertsJ. de ChadarĂŠvian\" data-hash=\"7982\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/The-vascular-groove-sign%3A-a-new-CT-finding-with-Liu-Kujak/991212cffbe9c71ab11fae2c148c3ed7cd58e8ef/figure/6\" data-tags=\"April2025\" height=\"330\" src=\"https://image.prepladder.com/notes/DECXKs75Q3sRIPg4l0zI1744052381.png\" width=\"500\"/>\n<ul>\n<li>Perifollicular hemorrhage</li>\n<li><strong>Frog-like <span class=\"customMeta\" data-dictid=\"115643fed616927771961316effc71\">posture</span> (semiflexion at hips and knees): Due to the inability to move limbs due to pain (pseudoparalysis).</strong></li>\n<li><strong>Scorbutic rosary</strong> (angular swellings at the <span class=\"customMeta\" data-dictid=\"bfa9e996381692777185cdc8709772\">costochondral</span> <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> arising due to <span class=\"customMeta\" data-dictid=\"98c8f7f96f1692777199295afb1d35\">subperiosteal</span> bleed)</li>\n</ul>\n<p><img alt=\"RA111\" data-author=\"\" data-hash=\"9045\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uvdbBqvkEqDW6DYBYjso1744343111.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Genu varum (bow-legs) or <span class=\"customMeta\" data-dictid=\"7e0d837a391692777188b2820de5f4\">Genu</span> valgum (knock-knees)</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Double-malleoli sign: </strong>The <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"6a7ff3e34716927771914c22e9fe4e\">malleolus</span> of the ankles has two bony prominences instead of one.</li>\n<li>Waddling gait</li>\n<li>Frontal bossing</li>\n<li>Delayed <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">closure</span> of <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> fontanelle</li>\n<li><strong>Craniotabes</strong> (soft skull bones with ping-pong ball consistency)</li>\n<li>Delayed <span class=\"customMeta\" data-dictid=\"76e17c45ef16927771851bc19cfc04\">dentition</span> and <span class=\"customMeta\" data-dictid=\"eff7c4fbc81692777187c2b449e4a7\">enamel</span> hypoplasia.</li>\n<li><strong>Rachitic rosary</strong><strong> </strong>(anterior <span class=\"customMeta\" data-dictid=\"06e0403a9c16927771846fde1c53f8\">chest wall</span> has a <span class=\"customMeta\" data-dictid=\"db8c3d4b9e1692777182a03a530a28\">beaded</span> appearance due to <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of <span class=\"customMeta\" data-dictid=\"bfa9e996381692777185cdc8709772\">costochondral</span> <span class=\"customMeta\" data-dictid=\"c6f61cdbe41692777183fdc8f95f96\">cartilage</span> junctions)</li>\n</ul>\n\t\t\t <img alt=\"RA112\" data-author=\"\" data-hash=\"9046\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/iVMHaOyg43mSG1fBowU01744343113.png\"/>\n<ul>\n<li><strong>Harrison sulcus:</strong> Depression along the lower border of the chest at the site of <span class=\"customMeta\" data-dictid=\"c88a7c1a0116927771909b2463968d\">insertion</span> of the diaphragm.</li>\n<li>Deformity of the hips: <strong>Coxa valga </strong>(femoral neck-shaft angle is increased) or <strong>coxa vara</strong> (femoral neck-shaft angle decreased)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pencil-thin cortex</li>\n<li><strong>A white line of Frankel is </strong>present (dense zone of <span class=\"customMeta\" data-dictid=\"e141602f62169277719672727e4f53\">provisional</span> <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> at the growing metaphysis, giving a white line)</li>\n<li><strong>Trummerfeldâs zone or <span class=\"customMeta\" data-dictid=\"fa5df84be0169277719814b6ea3f88\">Scorbutic</span> zone </strong>(black area adjacent to the white line of Frankel, due to lack of mineralisation of osteoid)</li>\n<li><strong>Wimberger's ring</strong> (epiphysis is small with a well-defined <span class=\"customMeta\" data-dictid=\"934e9f88af169277719847f1a0728f\">sclerotic</span> margin, ring-shaped)</li>\n<li><strong>Pelkan's <span class=\"customMeta\" data-dictid=\"77dc1bdd7416927771991cd9877b25\">spur</span> </strong>(extensions at the metaphysis)</li>\n</ul>\n<br/>\n<img alt=\"RA113\" data-author=\"\" data-hash=\"9047\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/XXnoEJ0bsYPbMCZWFnmL1744343113.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Widening of the <span class=\"customMeta\" data-dictid=\"3480d51034169277718862050fed12\">growth plate</span> <strong>(Option A)</strong>.</li>\n<li><strong>White Line of Frankel:</strong> Absent in active <span class=\"customMeta\" data-dictid=\"3bbd4ac09b16927771974d75a8b355\">rickets</span> <strong>(Option D)</strong>; present in <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> <span class=\"customMeta\" data-dictid=\"3bbd4ac09b16927771974d75a8b355\">rickets</span> after treatment.</li>\n<li>Splaying (widening) of bones.</li>\n<li>Cupping (concavity) <strong>(Option B) </strong>and fraying or (irregular margin) of bone ends.</li>\n</ul>\n<p><img alt=\"RA114\" data-author=\"\" data-hash=\"9048\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/xKqfzA5QF2q6wOn4BcI61744343114.png\"/></p>\n<p><img alt=\"RA115\" data-author=\"\" data-hash=\"9049\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/C155CfCov6Ib0duFQvZx1744343115.png\"/></p>\n<ul>\n<li><strong>Protrusio acetabuli </strong>and<strong> <span class=\"customMeta\" data-dictid=\"040475061e169277720068bf4101ac\">triradiate</span> <span class=\"customMeta\" data-dictid=\"ce2b48d83d1692777185427cee6c98\">deformity</span> </strong>of the pelvis.</li>\n</ul>\n<img alt=\"RA116\" data-author=\"\" data-hash=\"9050\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/vKrd27vhGoIWsZefMXHq1744343208.png\"/><br/>\n\t\t\t </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ZE1HtonuTYas6PVG1stJ1746779101.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 35 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 60-year-old patient presents with an inability to bear weight following a trivial trauma. X-rays of the pelvis and thigh reveal lytic lesions with cortical destruction. She has a history of weight loss. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Eosinophilic granuloma", "correct": false}, {"label": "B", "text": "Disseminated TB", "correct": false}, {"label": "C", "text": "Brown tumor", "correct": false}, {"label": "D", "text": "Metastasis", "correct": true}], "correct_answer": "D. Metastasis", "question_images": ["https://image.prepladder.com/content/qA7uP8UyOiizlSthj08e1741855302.png", "https://image.prepladder.com/content/n5nsVnk6Yewwbr19PK3g1741855326.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:620px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Common Metastatic Tumors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Lung <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">carcinoma</span> (male)</li>\n<li>Breast <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">carcinoma</span> (female)</li>\n<li>Prostate <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">carcinoma</span> <strong>(Osteoblastic)</strong></li>\n<li>Thyroid carcinoma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Clinical Features</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Known Primary Malignancy:\n\t\t\t\t<ul>\n<li>Bone pain (common in spine, ribs, extremities)</li>\n<li>Pathological <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> <strong>(common in spine)</strong></li>\n</ul>\n</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>Unknown Primary Malignancy:\n\t\t\t\t<ul>\n<li>Bone pain leading to destructive <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> diagnosis</li>\n<li>Pathological <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> due to weakened bone</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Malignancies Presenting with Silent Primary</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Thyroid carcinoma</li>\n<li>Renal cell carcinoma</li>\n<li>Bladder carcinoma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Common Sites of Metastasis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Vertebral bodies</li>\n<li>Ribs</li>\n<li>Pelvis</li>\n<li>Humerus</li>\n<li>Femur</li>\n<li>Uncommon <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> to elbow and knee</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the given fracture:", "options": [{"label": "A", "text": "Burst fracture", "correct": false}, {"label": "B", "text": "Compression fracture", "correct": false}, {"label": "C", "text": "Chance fracture", "correct": true}, {"label": "D", "text": "Impacted fracture", "correct": false}], "correct_answer": "C. Chance fracture", "question_images": ["https://image.prepladder.com/content/mQNAkGQLCZpyF9k6ny6E1724749423.png"], "explanation_images": [], "explanation": "<p>Correct Option C â Chance fractu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the marked ligament?", "options": [{"label": "A", "text": "PCL", "correct": true}, {"label": "B", "text": "ACL", "correct": false}, {"label": "C", "text": "Patellar tendon", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. PCL", "question_images": ["https://image.prepladder.com/notes/DVp1pIzt7AhgrL7RdI0z1746182421.png"], "explanation_images": ["https://image.prepladder.com/content/zP1eYSmb4FGDTkbAH7Rh1745998788.png", "https://image.prepladder.com/content/OywOWjnY61xk4k2PnXaH1745998788.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Structure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Function</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Injury Characteristics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>PCL (Posterior <span class=\"customMeta\" data-dictid=\"0faa43e76516927771851bff22a1e2\">Cruciate</span> Ligament)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Back of the knee joint</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Prevents <span class=\"customMeta\" data-dictid=\"ca6af868811692777200ce067e9db9\">tibia</span> from sliding backward, stabilizes knee</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Less common than ACL injury; caused by high-impact trauma (e.g., car accidents, contact sports); symptoms include instability, pain, and swelling</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>ACL (Anterior <span class=\"customMeta\" data-dictid=\"0faa43e76516927771851bff22a1e2\">Cruciate</span> Ligament)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Front of the knee joint</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Prevents <span class=\"customMeta\" data-dictid=\"ca6af868811692777200ce067e9db9\">tibia</span> from sliding forward, controls rotational movement</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Common in sports with sudden stops, direction changes, or jumps (e.g., football, basketball, skiing); symptoms include pain, swelling, and functional loss</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Patellar Tendon</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Connects <span class=\"customMeta\" data-dictid=\"615557ed3a169277719497f86e830b\">patella</span> (kneecap) to tibia</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Enables knee extension during walking and running</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Injured due to trauma or overuse; symptoms include pain, swelling, and difficulty straightening the knee</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most radiosensitive tissue in our body?", "options": [{"label": "A", "text": "Skin", "correct": false}, {"label": "B", "text": "Muscles", "correct": false}, {"label": "C", "text": "Bone marrow", "correct": true}, {"label": "D", "text": "Nervous tissue", "correct": false}], "correct_answer": "C. Bone marrow", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Tissue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Radiosensitivity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Reason</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bone marrow</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Highly radiosensitive</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Contains rapidly dividing stem cells for blood cell production</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lymphoid tissue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Highly radiosensitive</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rapid cell turnover, easily damaged by radiation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Gastrointestinal mucosa</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Moderately radiosensitive</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Epithelial cells divide rapidly</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Skin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Moderate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Basal layer is sensitive, but outer layers provide some protection</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Muscle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Radioresistant</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cells do not divide frequently</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Nervous tissue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Highly radioresistant</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Neurons are non-dividing cells and less affected by radiation</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 15-year-old patient with a history of spinal tuberculosis was brought to the hospital with low-grade fever, dull backache, and persistent flexion of the hip joint. Hip joint motion was limited and painful. Identify the muscle affected in the CT image.", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2", "correct": true}, {"label": "C", "text": "3", "correct": false}, {"label": "D", "text": "4", "correct": false}], "correct_answer": "B. 2", "question_images": ["https://image.prepladder.com/notes/vRNYNjglZUXQGhyzAKME1746444603.png"], "explanation_images": ["https://image.prepladder.com/notes/tEt7sJJheJLi5MFgbNnv1746444633.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Spinal TB (Pottâs Disease)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Involves lower <span class=\"customMeta\" data-dictid=\"3c6021096816927772007954fcc158\">thoracic</span> and upper <span class=\"customMeta\" data-dictid=\"683192f6b21692777191ae16feee76\">lumbar</span> <span class=\"customMeta\" data-dictid=\"9c0b99fa0816927772010e947b4ef6\">vertebrae</span> in adults; and upper <span class=\"customMeta\" data-dictid=\"3c6021096816927772007954fcc158\">thoracic</span> spine in children.</p>\n<p>Lesions spread to adjacent <span class=\"customMeta\" data-dictid=\"9c0b99fa0816927772010e947b4ef6\">vertebrae</span> and <span class=\"customMeta\" data-dictid=\"95a8e326831692777190c5101eb835\">intervertebral</span> disks.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Advanced Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Collapse of <span class=\"customMeta\" data-dictid=\"9c0b99fa0816927772010e947b4ef6\">vertebrae</span> leads to <span class=\"customMeta\" data-dictid=\"67deccee6a16927771911e0dcd1c3c\">kyphosis</span> <strong>(gibbus deformity)</strong>.</li>\n<li>Paravertebral cold abscesses:\n\t\t\t\t<ul>\n<li><strong>Upper spine: </strong>Abscess may<strong> penetrate the <span class=\"customMeta\" data-dictid=\"06e0403a9c16927771846fde1c53f8\">chest wall</span> as a soft tissue mass.</strong></li>\n<li><strong>Lower spine: </strong>May track to<strong> the inguinal region or <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> a <span class=\"customMeta\" data-dictid=\"1ca45620ed1692777196a47f648338\">psoas</span> abscess.</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis of <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">Spinal</span> TB</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Imaging (CT/MRI): </strong>Shows characteristic lesions, suggesting TB aetiology.</li>\n<li>Differential Diagnosis: Includes tumours and infections like <span class=\"customMeta\" data-dictid=\"f6332ef2d21692777196294f154e57\">pyogenic</span> bacterial osteomyelitis.</li>\n<li>Confirmation: <strong>Aspiration or <span class=\"customMeta\" data-dictid=\"754ab07a2e1692777183ed178c883d\">biopsy</span> confirms TB</strong> via positive cultures and typical histology.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Paraplegia</strong>: Due to <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> or <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> cord compression; requires emergency <span class=\"customMeta\" data-dictid=\"dd824a31e71692777186c7f8168998\">drainage</span> if caused by a large abscess.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 13-year-old boy presents to you with a limitation of abduction and internal rotation of the left hip. The x-ray appearance of his left hip joint is shown in the below image. What is the diagnosis of this patient?", "options": [{"label": "A", "text": "Slipped capital femoral epiphysis", "correct": true}, {"label": "B", "text": "Perthes disease", "correct": false}, {"label": "C", "text": "Development of dysplasia of the hip", "correct": false}, {"label": "D", "text": "Ankylosing spondylitis", "correct": false}], "correct_answer": "A. Slipped capital femoral epiphysis", "question_images": ["https://image.prepladder.com/content/NQzzoqZ2UxMVodNr2UMU1746697116.png"], "explanation_images": ["https://image.prepladder.com/content/w9wfKE29705bo07UlkBh1746697211.png", "https://image.prepladder.com/content/IYdkEE16LkEphsvyJQho1746697228.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "10-year-old girl presents to the OPD with a back deformity. What is the likely cause?", "options": [{"label": "A", "text": "Congenital", "correct": false}, {"label": "B", "text": "NF1", "correct": false}, {"label": "C", "text": "Idiopathic", "correct": true}, {"label": "D", "text": "Neuromuscular", "correct": false}], "correct_answer": "C. Idiopathic", "question_images": ["https://image.prepladder.com/content/Pk9ov9YPNq2ZCj6fxHMb1748159076.png"], "explanation_images": [], "explanation": "<p>Correct Answer C- Idiopath\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Based on the provided image, what possible diagnosis can be determined?", "options": [{"label": "A", "text": "Multiple myeloma", "correct": false}, {"label": "B", "text": "Ankylosing spondylitis", "correct": false}, {"label": "C", "text": "Pyogenic spondylitis", "correct": false}, {"label": "D", "text": "Pottâs spine", "correct": true}], "correct_answer": "D. Pottâs spine", "question_images": ["https://image.prepladder.com/content/xD5dYQT8mb7inu0JLpnk1697440029.png"], "explanation_images": ["https://image.prepladder.com/content/SoS5kpSqnieQOYbBHdOt1691385979.png"], "explanation": "<p>Correct Option D- Pottâs spine: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the probable cause of a back deformity in a 10-year-old female patient visiting the outpatient department?", "options": [{"label": "A", "text": "Congenital", "correct": false}, {"label": "B", "text": "NF1", "correct": false}, {"label": "C", "text": "Idiopathic", "correct": true}, {"label": "D", "text": "Neuromuscular", "correct": false}], "correct_answer": "C. Idiopathic", "question_images": ["https://image.prepladder.com/content/DLAQ88Lre9Znu68iTIPj1691377755.jpg"], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The X Ray of the skull as shown in the image given below is seen in:", "options": [{"label": "A", "text": "Hyperparathyroidism", "correct": true}, {"label": "B", "text": "Multiple myeloma", "correct": false}, {"label": "C", "text": "Hyperthyroidism", "correct": false}, {"label": "D", "text": "Pagetâs disease", "correct": false}], "correct_answer": "A. Hyperparathyroidism", "question_images": ["https://image.prepladder.com/content/puQT9FlRULxoB7hYg2An1691498960.png"], "explanation_images": ["https://image.prepladder.com/content/CzFGOquMw1EqNgG9ewWJ1695368212.png"], "explanation": "<p>Correct Option A: Hyperparath\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 20 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 50-year-old patient is admitted to the ICU after experiencing a cardiac arrest. CT imaging is given below. What is this radiological finding called?", "options": [{"label": "A", "text": "Reversal Sign", "correct": false}, {"label": "B", "text": "White Cerebellum Sign", "correct": true}, {"label": "C", "text": "Pseudo subarachnoid hemorrhage", "correct": false}, {"label": "D", "text": "Delta Sign", "correct": false}], "correct_answer": "B. White Cerebellum Sign", "question_images": ["https://image.prepladder.com/notes/wgimpvcmwmJtFxBw3xs51744127543.png"], "explanation_images": ["https://image.prepladder.com/notes/wgimpvcmwmJtFxBw3xs51744127543.png", "https://image.prepladder.com/notes/iHOae1thIa8zItZZ1atG1744129294.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Global cerebral hypoperfusion</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Epidemiology</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Older children:</strong> <span class=\"customMeta\" data-dictid=\"5031a7245c1692777186f7e7aabc06\">drowning</span> and asphyxiation.</li>\n<li><strong>Adults:</strong> <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrest or <span class=\"customMeta\" data-dictid=\"75a3b02a801692777184b9cb7f0c0a\">cerebrovascular</span> disease, leading to secondary <span class=\"customMeta\" data-dictid=\"9f81027f0116927771892823259e5d\">hypoxemia</span> or hypoperfusion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Presentation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Patients typically present after an <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> event (e.g., near-drowning, asphyxia, cardiac/respiratory arrest).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathology</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Severe global hypoxic-ischemic injury</li>\n<li>Grey matter is particularly vulnerable to injury because of its high <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> demands for oxygen and glucose, along with its abundance of <span class=\"customMeta\" data-dictid=\"978bd0e89f1692777196add72e1254\">postsynaptic</span> <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> receptors, which make it more <span class=\"customMeta\" data-dictid=\"607476ab371692777196d0cb2f13bc\">prone</span> to <span class=\"customMeta\" data-dictid=\"661cebc9c7169277718734a38fa71b\">excitotoxicity</span> from excessive <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> stimulation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological findings</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA107\" data-author=\"\" data-hash=\"8246\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"436\" src=\"https://image.prepladder.com/notes/wgimpvcmwmJtFxBw3xs51744127543.png\" width=\"350\"/>\n<ul>\n<li>Diffuse <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> with <span class=\"customMeta\" data-dictid=\"dc0035cd191692777187b9b8b2af69\">effacement</span> of CSF-containing spaces</li>\n</ul>\n<p> </p>\n<p><strong>Reversal Sign</strong>: <strong>(Option A ruled out)</strong></p>\n<p><img alt=\"RA1015\" data-author=\"\" data-hash=\"8247\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"455\" src=\"https://image.prepladder.com/notes/iHOae1thIa8zItZZ1atG1744129294.png\" width=\"400\"/></p>\n<ul>\n<li>Involves the <strong>reversal of normal CT attenuation</strong> between grey and white matter.</li>\n<li>Linked to distension of deep <span class=\"customMeta\" data-dictid=\"0a36e18386169277719259641cf29b\">medullary</span> veins due to partial <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> outflow <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> from elevated <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> pressure.</li>\n<li>White matter appears of higher <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> than grey matter.</li>\n</ul>\n<p><strong>White <span class=\"customMeta\" data-dictid=\"a9c41a58d816927771847775d63d96\">Cerebellum</span> Sign</strong>: <strong>(Option B ruled out)</strong></p>\n<ul>\n<li>Seen with <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> and <strong>hypoattenuation of cerebral hemispheres</strong>, sparing the <span class=\"customMeta\" data-dictid=\"a9c41a58d816927771847775d63d96\">cerebellum</span> and brainstem.</li>\n<li>Makes the<strong> <span class=\"customMeta\" data-dictid=\"a9c41a58d816927771847775d63d96\">cerebellum</span> and brainstem</strong> appear <strong>hyperattenuated </strong>relative to cerebral hemispheres.</li>\n</ul>\n<ul>\n<li><strong>Pseudo <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> </strong><strong>(Option C)</strong>: caused by cerebral edema, <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> parenchymal attenuation, swelling, and <span class=\"customMeta\" data-dictid=\"2b87f64333169277718751772e06ef\">engorged</span> <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> structures, leading to the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space appearing hyperdense, mimicking a hemorrhage.</li>\n</ul>\n<ul>\n<li>Both the <span class=\"customMeta\" data-dictid=\"82343f61171692777197b4a08bc719\">reversal</span> sign and the white <span class=\"customMeta\" data-dictid=\"a9c41a58d816927771847775d63d96\">cerebellum</span> sign are associated with severe brain injury and poor neurological outcomes.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male patient with a history of hypertension presents with a sudden onset of severe headache, vomiting, and right-sided weakness. Additionally, he exhibits altered sensorimotor integration and difficulty with voluntary movement control. His blood pressure is recorded at 190/110 mmHg. A CT scan of the head is performed with findings given below Based on the findings, Which artery is most likely involved in this case?", "options": [{"label": "A", "text": "Anterior choroidal artery", "correct": false}, {"label": "B", "text": "Lenticulostriate artery", "correct": true}, {"label": "C", "text": "Posterior cerebral artery", "correct": false}, {"label": "D", "text": "Middle meningeal artery", "correct": false}], "correct_answer": "B. Lenticulostriate artery", "question_images": ["https://image.prepladder.com/notes/J6xUfAes0XFfiz8DCND41743953260.png"], "explanation_images": ["https://image.prepladder.com/notes/J6xUfAes0XFfiz8DCND41743953260.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old patient presents with bilateral thalamic and basal ganglia symptoms, including motor weakness and sensory disturbances. MRI reveals bilateral infarcts in these regions. Which type of venous thrombosis is most likely responsible for these findings?", "options": [{"label": "A", "text": "Superior sagittal sinus thrombosis", "correct": false}, {"label": "B", "text": "Internal cerebral vein thrombosis", "correct": true}, {"label": "C", "text": "Lateral venous sinus thrombosis", "correct": false}, {"label": "D", "text": "Vein of Labbe thrombosis", "correct": false}], "correct_answer": "B. Internal cerebral vein thrombosis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/AHwf6Apnfy65S2CuZj2M1744124227.png", "https://image.prepladder.com/notes/yrJhTDnai3scz8Qq7OfH1744127248.png", "https://image.prepladder.com/notes/6aOi9PcyLcS387mFoZGv1744124283.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Venous Anatomy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\">\n<p><img alt=\"RA105\" data-author=\"\" data-hash=\"8245\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"550\" src=\"https://image.prepladder.com/notes/yrJhTDnai3scz8Qq7OfH1744127248.png\" width=\"550\"/></p>\n<p style=\"text-align:left\">Cerebral veins are categorized into <strong>external </strong>(superficial) and<strong> internal </strong>veins, draining the outer and inner regions of the cerebral hemisphere.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<h4 style=\"text-align:center\"><strong>External Cerebral Veins</strong></h4>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Superior Cerebral Veins</strong>: Typically 8 to 12 in number, these veins drain the upper parts of the hemisphere, entering the superior <span class=\"customMeta\" data-dictid=\"862a709fba1692777198c35e274398\">sagittal</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> after piercing the <span class=\"customMeta\" data-dictid=\"dd3534c97c16927771823c0d04f685\">arachnoid</span> mater.</li>\n<li><strong>Middle Cerebral Veins</strong>: Comprising four veins (two <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> and two deep), these veins drain the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> sulcus, connecting to the <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">cavernous</span> sinus, superior <span class=\"customMeta\" data-dictid=\"862a709fba1692777198c35e274398\">sagittal</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> <strong>(Trolard)</strong>, and <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> sinus<strong> (Labbe)</strong>. The<strong> deep veins</strong> <strong>merge</strong> with the <strong>anterior cerebral <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> </strong>to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> the<strong> <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> vein</strong>.</li>\n<li><strong>Inferior Cerebral Veins</strong>: Numerous smaller veins that drain the <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> surfaces of the <span class=\"customMeta\" data-dictid=\"d702dfe10816927771881b37be4e4a\">hemisphere</span> into nearby <span class=\"customMeta\" data-dictid=\"bec08dbe0c16927771864d7774d7b0\">dural</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> sinuses.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<h4 style=\"text-align:center\"><strong>Additional Veins</strong></h4>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Anterior Cerebral Vein</strong>: Drains parts of the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> surface alongside the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> cerebral artery.</li>\n<li><strong>Basal <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">Vein</span> (of Rosenthal)</strong>: Formed by the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> cerebral, deep middle cerebral, and <span class=\"customMeta\" data-dictid=\"242565d1401692777199d6803d9a9d\">striate</span> veins, this <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> runs around the <span class=\"customMeta\" data-dictid=\"d26464df7216927771923483619265\">midbrain</span> and drains into the great cerebral <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> (of Galen), receiving tributaries from various brain structures.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Internal Cerebral Veins</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Located on either side of the midline in the <span class=\"customMeta\" data-dictid=\"8166f2894b1692777200137ca2ff71\">tela</span> choroidea of the 3rd ventricle.</li>\n<li>Formed at the <span class=\"customMeta\" data-dictid=\"769fa5be3616927771906f8ae8b053\">interventricular</span> <span class=\"customMeta\" data-dictid=\"9f027343dd16927772039cf6b0c8e4\">foramen</span> (of Monro) by the thalamostriate, septal, and <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> veins.</li>\n<li>Drain specific brain regions:\n\t\t\t\t<ul>\n<li>Thalamostriate (thalamus and <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia)</li>\n<li>Septal (septum pellucidum)</li>\n<li>Choroidal (choroid plexus).</li>\n</ul>\n</li>\n<li>Unite beneath the <span class=\"customMeta\" data-dictid=\"2c808950f11692777199ccd2c1f2c1\">splenium</span> of the <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> <span class=\"customMeta\" data-dictid=\"da26c5f3191692777183dd100bbd81\">callosum</span> to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> the<strong> great cerebral vein</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Great Cerebral Vein</strong> <strong>of Galen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A single <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> (about 2 cm long) formed by the internal cerebral veins.</li>\n<li>Receives<strong> <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> veins </strong>and joins the<strong> <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"862a709fba1692777198c35e274398\">sagittal</span> sinu</strong>s to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> the<strong> straight sinus</strong>.</li>\n<li><strong>Tributaries</strong> include:\n\t\t\t\t<ul>\n<li>Internal cerebral veins</li>\n<li>Basal veins</li>\n<li>Veins from the <span class=\"customMeta\" data-dictid=\"0f08cdc73216927771848e5b064d11\">colliculi</span> (tectum of the midbrain)</li>\n<li>Veins from the <span class=\"customMeta\" data-dictid=\"a9c41a58d816927771847775d63d96\">cerebellum</span> and adjacent <span class=\"customMeta\" data-dictid=\"77dc7a0ab81692777194dba7ab78ab\">occipital</span> lobes</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old woman presents with a severe headache that started 2 days ago. She reports associated symptoms of nausea, vomiting, and a few episodes of seizure. A history of recent oral contraceptive use is present. On examination, she has a mild altered mental status but no focal deficits. A CECT is given below. What specific sign on CT is characteristic of this diagnosis?", "options": [{"label": "A", "text": "Empty delta sign", "correct": true}, {"label": "B", "text": "Empty theca sign", "correct": false}, {"label": "C", "text": "Empty sella sign", "correct": false}, {"label": "D", "text": "Dense vein sign", "correct": false}], "correct_answer": "A. Empty delta sign", "question_images": ["https://image.prepladder.com/content/1QMRTHARzuGGtLNJOAad1741232831.png"], "explanation_images": ["https://image.prepladder.com/content/MahfcLNS9UGIxaXVADVx1741232929.png", "https://image.prepladder.com/content/JnOOv6ILd7arSCzXzDxe1741233005.png", "https://image.prepladder.com/content/iVGS8oVeKyCOCFkvL6WV1741233149.png", "https://image.prepladder.com/content/vQ60i1BGY90tqw4DZbxO1741233191.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Central <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis</strong></p>\n<p style=\"text-align:center\"> </p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CVT should be suspected in patients presenting with headaches, seizures, or encephalopathy.</li>\n<li>Can occur in <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> or deep <span class=\"customMeta\" data-dictid=\"bec08dbe0c16927771864d7774d7b0\">dural</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> sinuses, affecting either isolated veins or as part of broader <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis.</li>\n<li>Factors like<strong> <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> infections</strong>, trauma, dehydration,<strong> pregnancy</strong>, <strong>oral contraceptives</strong>, smoking, and<strong> vasculitis</strong> (e.g., Behçet disease) can trigger CVT. If absent, a <span class=\"customMeta\" data-dictid=\"70158d6a8316927772008b29ca8100\">thrombophilia</span> screening is necessary.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT Findings</strong>:</p>\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"283\" src=\"https://image.prepladder.com/content/MahfcLNS9UGIxaXVADVx1741232929.png\" width=\"575\"/></p>\n<ul>\n<li>The <strong>empty <span class=\"customMeta\" data-dictid=\"f7d3133242169277718518c059ad55\">delta</span> sign</strong>, visible in contrast-enhanced CT scans, indicates <span class=\"customMeta\" data-dictid=\"bec08dbe0c16927771864d7774d7b0\">dural</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">thrombosis</span> in the<strong> superior <span class=\"customMeta\" data-dictid=\"862a709fba1692777198c35e274398\">sagittal</span> sinus</strong> as a <strong>triangular <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> </strong>outlined by contrast, representing a thrombus. <strong>(Option A)</strong></li>\n<li>The<strong> dense <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> sign</strong>, a <span class=\"customMeta\" data-dictid=\"1dfb6906b91692777189e0acce4f86\">hyperdense</span> vessel sign indicating hyperattenuating <span class=\"customMeta\" data-dictid=\"56c933e0d41692777200b713c46640\">thrombus</span> due to <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> thrombosis, is found in <strong>cortical veins or <span class=\"customMeta\" data-dictid=\"bec08dbe0c16927771864d7774d7b0\">dural</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> sinuses</strong>. <strong>(Option D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI Findings</strong>:</p>\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"294\" src=\"https://image.prepladder.com/content/JnOOv6ILd7arSCzXzDxe1741233005.png\" width=\"457\"/></p>\n<ul>\n<li>Loss of normal flow void; <span class=\"customMeta\" data-dictid=\"d32945833c16927772005b5e05a44f\">thrombosed</span> vessels may appear <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> on T1 and T2 sequences. Very <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"56c933e0d41692777200b713c46640\">thrombus</span> can be <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> on T2, mimicking flow voids. Additionally, slow flow can also result in<strong> loss of the flow void.</strong></li>\n<li><strong>MR <span class=\"customMeta\" data-dictid=\"8a7362882e1692777201ef793c3fd4\">venography</span> (MRV) </strong>shows a loss of flow signal or irregularity, indicating a thrombus.</li>\n<li><strong>SWI </strong>(Susceptibility Weighted Imaging) can <strong>highlight <span class=\"customMeta\" data-dictid=\"d32945833c16927772005b5e05a44f\">thrombosed</span> veins</strong> and detect <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> hemorrhage.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Empty <span class=\"customMeta\" data-dictid=\"2ae158b0bc1692777200039e41de96\">theca</span> sign </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Empty <span class=\"customMeta\" data-dictid=\"02db2e09e91692777198e14771cb3b\">sella</span> sign </strong><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"310\" src=\"https://image.prepladder.com/content/iVGS8oVeKyCOCFkvL6WV1741233149.png\" width=\"340\"/></p>\n<ul>\n<li>The empty thecal <span class=\"customMeta\" data-dictid=\"59ae5630de16927771988a866d1dea\">sac</span> sign occurs when the thecal <span class=\"customMeta\" data-dictid=\"59ae5630de16927771988a866d1dea\">sac</span> appears empty on <span class=\"customMeta\" data-dictid=\"683192f6b21692777191ae16feee76\">lumbar</span> spine MRI, particularly on T2-weighted images.</li>\n<li>It is seen in<strong> <span class=\"customMeta\" data-dictid=\"396cb274df16927771803e151a1109\">Adhesive</span> arachnoiditis</strong>.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"376\" src=\"https://image.prepladder.com/content/vQ60i1BGY90tqw4DZbxO1741233191.png\" width=\"417\"/></p>\n<ul>\n<li>It occurs when the <span class=\"customMeta\" data-dictid=\"b775f0c475169277719593c573f6ff\">pituitary</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> is shrunken or absent, with <span class=\"customMeta\" data-dictid=\"123c47549916927771854892334fb9\">CSF</span> <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> the <span class=\"customMeta\" data-dictid=\"02db2e09e91692777198e14771cb3b\">sella</span> turcica.</li>\n<li>Seen in <strong>idiopathic <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> hypertension</strong> &amp; <strong>Sheehan's syndrome</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 75-year-old female with a history of stroke presents for follow-up imaging 6 months after an acute right middle cerebral artery (MCA) infarct. CT head is taken and is shown below. Which of the following imaging findings is most characteristic in this case?", "options": [{"label": "A", "text": "T2 hypointensity in the ipsilateral corticospinal tract", "correct": false}, {"label": "B", "text": "High signal intensity on DWI and low signal on ADC", "correct": false}, {"label": "C", "text": "Enlarged sulci and ventricles with CSF-like signal intensity", "correct": true}, {"label": "D", "text": "Ipsilateral cerebellar volume loss due to large MCA infarcts", "correct": false}], "correct_answer": "C. Enlarged sulci and ventricles with CSF-like signal intensity", "question_images": ["https://image.prepladder.com/content/pGAy3GFzavBKFOmF6fA41741213187.png"], "explanation_images": ["https://image.prepladder.com/content/x18iA2BRsXQIOOS8COL81741213270.png", "https://image.prepladder.com/content/C20Id3z7FaRL2rRyKGr81741213323.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 64-year-old male presents with left-sided weakness and speech difficulty for 8 hours. NCCT shows no hemorrhage, and CTAngiography reveals a proximal MCA occlusion. DWI shows a large infarct volume (&amp;gt;70 ml). According to the Massachusetts General Hospital (MGH) Acute Stroke Imaging Algorithm, what is the most appropriate next step for this patient?", "options": [{"label": "A", "text": "Proceed with intra-arterial thrombectomy (IAT)", "correct": false}, {"label": "B", "text": "Continue with tPA infusion and monitor", "correct": false}, {"label": "C", "text": "Consider perfusion imaging with CT or MRI", "correct": true}, {"label": "D", "text": "Administer aspirin and start rehabilitation", "correct": false}], "correct_answer": "C. Consider perfusion imaging with CT or MRI", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ap3shGI4EvkmmVHSucM61744121609.png", "https://image.prepladder.com/notes/pcHKvEbQOIIonxl5TzQy1744121710.png", "https://image.prepladder.com/notes/7NKgYWzN3nd2Zg2sEKga1744121755.png", "https://image.prepladder.com/notes/KH2mp4jCg01kBfgECahg1744122172.png"], "explanation": "<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"text-align:center\"><strong>Radiological Findings</strong></td>\n</tr>\n<tr>\n<td colspan=\"2\"><strong>CT Scan</strong></td>\n</tr>\n<tr>\n<td><img alt=\"RA092\" data-author=\"\" data-hash=\"8237\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"511\" src=\"https://image.prepladder.com/notes/pcHKvEbQOIIonxl5TzQy1744121710.png\" width=\"400\"/></td>\n<td>\n<ul>\n<li>Investigation of choice.</li>\n<li>Characterized by cytotoxic edema, leading to significant but subtle changes in imaging.</li>\n<li>This condition represents <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> edema, which causes:\n\t\t\t\t<ul>\n<li>Loss of gray matter/white matter differentiation.</li>\n<li>Effacement of <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> sulci.</li>\n</ul>\n</li>\n<li>Early ischemic <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> hypodensity on CT is the hallmark of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> brain infarction, indicating <span class=\"customMeta\" data-dictid=\"ee77d507701692777190bfcf47b497\">irreversible</span> tissue damage and continual net water uptake.</li>\n<li>\n<p>Wedge shaped <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> infarct.</p>\n</li>\n<li>A <span class=\"customMeta\" data-dictid=\"56c933e0d41692777200b713c46640\">thrombus</span> in the <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> middle cerebral <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (MCA) may be visible during the <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> phase.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"56c933e0d41692777200b713c46640\">thrombus</span> appears as hyperattenuation on the CT scan.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:276px\">\n<ul>\n<li><strong>Objectives of Non-Enhanced <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">Cranial</span> CT in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> Stroke:</strong>\n<ul>\n<li>Exclude <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> to allow <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> therapy.</li>\n<li>Exclude alternative causes of neurological deficit.</li>\n<li>Assess <span class=\"customMeta\" data-dictid=\"7d8fbc62391692777190399f2b0126\">infarct</span> volume and calculate ASPECTS (Alberta Stroke Program Early CT Score).</li>\n<li>Detecting a <span class=\"customMeta\" data-dictid=\"1dfb6906b91692777189e0acce4f86\">hyperdense</span> vessel.</li>\n<li>Confirm <span class=\"customMeta\" data-dictid=\"7d8fbc62391692777190399f2b0126\">infarct</span> matches the clinical timeline and is not subacute.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:276px\"><strong>Diffusion-Weighted <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> (DWI)</strong></td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:276px\">\n<ul>\n<li>Has high sensitivity and specificity, detecting parenchymal hyperintensity as early as 5 minutes after <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> onset.</li>\n<li>Determines area of penumbra.</li>\n<li>DWI must be interpreted with an apparent <span class=\"customMeta\" data-dictid=\"9c760dcb641692777186f4cda5dc95\">diffusion</span> <span class=\"customMeta\" data-dictid=\"b530604f9d1692777184cf1541ae41\">coefficient</span> (ADC) map.</li>\n<li>Restricted <span class=\"customMeta\" data-dictid=\"9c760dcb641692777186f4cda5dc95\">diffusion</span> in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"7d8fbc62391692777190399f2b0126\">infarct</span> appears bright on <span class=\"customMeta\" data-dictid=\"75d6e5041416927771869c596d3aa7\">DWI</span> and dark on the ADC map.</li>\n<li>In rare cases, DWI-positive areas may not progress to <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> after early <span class=\"customMeta\" data-dictid=\"a9f8d3963116927771976cb0179891\">recanalization</span> treatments (IV agents or mechanical thrombectomy).</li>\n</ul>\n<img alt=\"RA093\" data-author=\"\" data-hash=\"8238\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"395\" src=\"https://image.prepladder.com/notes/7NKgYWzN3nd2Zg2sEKga1744121755.png\" width=\"500\"/><img alt=\"RA094\" data-author=\"\" data-hash=\"8239\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"512\" src=\"https://image.prepladder.com/notes/KH2mp4jCg01kBfgECahg1744122172.png\" width=\"400\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male with hypertension and atrial fibrillation presents with sudden right-sided weakness and speech difficulty, starting 1 hour ago. A non-contrast CT scan is performed and is shown below. Which of the following signs is marked (arrow) in this case?", "options": [{"label": "A", "text": "Sylvian fissure dot sign", "correct": false}, {"label": "B", "text": "Disappearing basal ganglia sign", "correct": false}, {"label": "C", "text": "Hyperdense basilar artery sign", "correct": true}, {"label": "D", "text": "Hyperdense middle cerebral artery (MCA) sign", "correct": false}], "correct_answer": "C. Hyperdense basilar artery sign", "question_images": ["https://image.prepladder.com/notes/lOMDPzR9B47wo4vf2woT1744120995.png"], "explanation_images": ["https://image.prepladder.com/notes/i4VRVcV1A1kwXOIkD8LE1744121065.png", "https://image.prepladder.com/notes/p5T4ZIdC3Xsvr2OHen1b1744121125.png", "https://image.prepladder.com/notes/5RAV6S35F3cq9GNCVXVh1744121191.png", "https://image.prepladder.com/notes/JTmdcvOfJNZa8AOh1acF1744121229.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 75-year-old male presents with a sudden onset of left-sided weakness and difficulty speaking. The emergency physician needs to determine the best initial imaging modality to assess for an acute ischemic stroke and potential hemorrhage. Which imaging technique should be performed first?", "options": [{"label": "A", "text": "MRI", "correct": false}, {"label": "B", "text": "CT Angiography", "correct": false}, {"label": "C", "text": "Non-Contrast CT", "correct": true}, {"label": "D", "text": "MR Angiography", "correct": false}], "correct_answer": "C. Non-Contrast CT", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/JTolCFTLH3q4nRmYhnhS1741211624.png", "https://image.prepladder.com/content/X4yYcYQ7i7xodhsgV1NQ1741211664.png", "https://image.prepladder.com/content/3dII7go5t1m898zkpCYc1741211823.png", "https://image.prepladder.com/content/059E48sd7NpV9FpTYYDQ1741211893.png", "https://image.prepladder.com/content/uHYuuG8LTIzPIH93pA2L1741211916.png", "https://image.prepladder.com/content/O3Fw4MfTZaiNHlFqfSy01741211946.png", "https://image.prepladder.com/content/n2MPUSp6icfD5Acf7GAr1741212019.png", "https://image.prepladder.com/content/vgafPbdaghsDJJukMVf21741212291.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:770px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Contrast CT </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT Angiography</strong><strong> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI </strong><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Earliest Signs of Ischemic Stroke: </strong>loss of <span class=\"customMeta\" data-dictid=\"55a682d72e16927771865bb4855ba3\">differentiation</span> between gray and white matter.</li>\n<li><strong>Loss of <span class=\"customMeta\" data-dictid=\"89c1dec8851692777190016cefdef4\">Insular</span> Ribbon Sign: </strong>seen when the middle cerebral <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> is involved, with the <span class=\"customMeta\" data-dictid=\"3f7ac0d87916927771907e4a5c9d1b\">insula</span> showing early changes.</li>\n</ul>\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"424\" src=\"https://image.prepladder.com/content/3dII7go5t1m898zkpCYc1741211823.png\" width=\"340\"/></p>\n<ul>\n<li><strong>Hyperdense Vessel Sign:</strong> In <span class=\"customMeta\" data-dictid=\"c7c23b05e116927771899b5232b3d7\">hyperacute</span> strokes, the <span class=\"customMeta\" data-dictid=\"56c933e0d41692777200b713c46640\">thrombus</span> appears dense, causing hyperattenuation of the occluded segment of the MCA.</li>\n<li>CT scan can also reveal whether there is <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> in the brain or damage to brain cells resulting from a stroke.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Provides high-resolution <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> of the <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> tree from the aortic <span class=\"customMeta\" data-dictid=\"9a89dd67841692777182ee412af263\">arch</span> to <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> vessels.</li>\n<li>Allows for functional <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> and assessment of collaterals.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Earliest Signs of Ischemic Stroke: </strong>restricted <span class=\"customMeta\" data-dictid=\"9c760dcb641692777186f4cda5dc95\">diffusion</span> on <span class=\"customMeta\" data-dictid=\"9c760dcb641692777186f4cda5dc95\">diffusion</span> weighted imaging.</li>\n<li>Is observed within a few minutes of arterial occlusion.</li>\n<li>Can identify changes in brain tissue and damage to brain cells.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:265px\">\n<ul>\n<li><strong>Uses:</strong>\n<ul>\n<li>Diagnosis of major stroke.</li>\n<li>To identify a <span class=\"customMeta\" data-dictid=\"c9f33964851692777185b94f619862\">contraindication</span> to treatment, like <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> or large infarct.</li>\n<li>To identify stroke <span class=\"customMeta\" data-dictid=\"efaf9e0192169277719278711f7f74\">mimic</span> such as brain tumor.</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:242px\">\n<ul>\n<li><strong>Use:</strong>\n<ul>\n<li>Detection of large vessel <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> (LVO).</li>\n</ul>\n</li>\n</ul>\n<p>   </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:263px\">\n<ul>\n<li><strong>Uses: </strong>\n<ul>\n<li>Most sensitive technique for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"bef027ba821692777190cb424e9554\">ischemic stroke</span> detection.</li>\n<li>Used in <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> diagnosis of minor stroke</li>\n<li>Typically during follow-up.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:265px\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"339\" src=\"https://image.prepladder.com/content/059E48sd7NpV9FpTYYDQ1741211893.png\" width=\"252\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:242px\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"320\" src=\"https://image.prepladder.com/content/uHYuuG8LTIzPIH93pA2L1741211916.png\" width=\"259\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:263px\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"326\" src=\"https://image.prepladder.com/content/O3Fw4MfTZaiNHlFqfSy01741211946.png\" width=\"280\"/></td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:650px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Artery </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Supply Site</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Middle Cerebral <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">Artery</span> (MCA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lateral <span class=\"customMeta\" data-dictid=\"70cc36bc1a1692777185d6cfa6e6b9\">convexity</span> of the cerebral hemisphere</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anterior Cerebral <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">Artery</span> (ACA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Frontal poles, superior surfaces, and all <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> surfaces of both cerebral hemispheres, except the <span class=\"customMeta\" data-dictid=\"87c21c267916927771835c18842bb9\">calcarine</span> cortex.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posterior Cerebral <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">Artery</span> (PCA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior midbrain, portions of the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> thalamus, the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"77dc7a0ab81692777194dba7ab78ab\">occipital</span> lobes and the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> and <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> portions of the <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> lobe.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anterior <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">Choroidal</span> Artery: Branch of Internal <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">Carotid</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">Artery</span> (ICA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Choroid <span class=\"customMeta\" data-dictid=\"3a9085a5761692777195417d7c03ae\">plexus</span> of the <span class=\"customMeta\" data-dictid=\"ca762506461692777190f12b43bb1a\">ipsilateral</span> <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"707de303e516927772011cb80f4028\">ventricle</span> and parts of the hippocampus, amygdala, uncus, internal capsule, <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lenticulostriate Branches: Branch of MCA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Caudate nucleus, <span class=\"customMeta\" data-dictid=\"86c230abe316927771889bbef8df5d\">globus</span> pallidus, putamen, and part of the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> limb of the internal capsule.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male presents to the emergency department with a sudden onset of severe headache and loss of consciousness. An MRI is performed shortly after the incident and shows a hyperintense lesion on T1-weighted images and a hypointense lesion on T2-weighted images, consistent with an acute hematoma. What would be the phase of blood in this condition?", "options": [{"label": "A", "text": "Deoxyhemoglobin", "correct": true}, {"label": "B", "text": "Oxyhemoglobin", "correct": false}, {"label": "C", "text": "Methemoglobin", "correct": false}, {"label": "D", "text": "Hemosiderin", "correct": false}], "correct_answer": "A. Deoxyhemoglobin", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/0lcVMeSscip5AJqmS5CG1743955383.png", "https://image.prepladder.com/notes/Jqdb1rKbWb0hresATDOc1743955431.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old male presents to the emergency department with confusion and headache. A CT scan of the brain is performed which shows as follows: The radiologist notes a characteristic appearance of increased spacing between the frontal lobes. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Porencephalic cyst", "correct": false}, {"label": "B", "text": "ACOM aneurysm", "correct": false}, {"label": "C", "text": "Pneumocephalus", "correct": true}, {"label": "D", "text": "Carotid cavernous fistula", "correct": false}], "correct_answer": "C. Pneumocephalus", "question_images": ["https://image.prepladder.com/notes/S7JH6q6jtM8mUObsWdo61743953625.png"], "explanation_images": ["https://image.prepladder.com/notes/y0DlghuFJ4O4os9TWzRN1743953729.png", "https://image.prepladder.com/notes/xMm1cnWotzHO9DNU4oEq1743953864.png", "https://image.prepladder.com/notes/rI8zotJcme1W7nqnid7a1743954976.png", "https://image.prepladder.com/notes/HmcoRpEiOmXFz8tilzNi1743955031.png", "https://image.prepladder.com/notes/8yutgOeVOwCSsquAaOuI1743955135.png", "https://image.prepladder.com/notes/5Fzu1NHnlGayoybDcTr61743955192.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old male is brought to the emergency department after a road traffic accident. He presents with loss of consciousness, altered mental status, decerebrate posturing, and widespread cerebral edema. A CT scan returns normal. After intubation, which MRI sequence is preferred for evaluating the extent of his neurological injuries?", "options": [{"label": "A", "text": "T1-weighted MRI (T1W)", "correct": false}, {"label": "B", "text": "T2-weighted MRI (T2W)", "correct": true}, {"label": "C", "text": "FLAIR (Fluid-Attenuated Inversion Recovery) MRI", "correct": false}, {"label": "D", "text": "Diffusion-weighted MRI (DWI)", "correct": false}], "correct_answer": "B. T2-weighted MRI (T2W)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/pJJxUo2YqcSzMXWHTlz41743953441.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:663px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location of Injury</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prognosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gray matter and <span class=\"customMeta\" data-dictid=\"faffdfe705169277720242bf7ee9b5\">white matter</span> interface</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Involves the initial site of axonal injury.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Relatively better prognosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>II</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Corpus callosum</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Involves the critical structure connecting the two hemispheres. Suggests more severe <span class=\"customMeta\" data-dictid=\"5744dac7511692777186db6f8e0c28\">disruption</span> of axonal pathways.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Worse <span class=\"customMeta\" data-dictid=\"e580b4033e169277719609af594c16\">prognosis</span> than <span class=\"customMeta\" data-dictid=\"d4ae50897e16927771884b5c46ba7d\">Grade</span> I</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>III</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Brain stem</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Involves the brain stem, which can significantly affect vital functions.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Associated with the worst prognosis</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Assertion (A): On CT scan, the bone cortex appears black, while on MRI, it appears white. Reason (R): The appearance of structures on CT and MRI depends on the density of tissues and the presence of hydrogen atoms.", "options": [{"label": "A", "text": "Both Assertion (A) and Reason (R) are true, and Reason (R) is the correct explanation of Assertion (A).", "correct": false}, {"label": "B", "text": "Both Assertion (A) and Reason (R) are true, but Reason (R) is not the correct explanation of Assertion (A).", "correct": false}, {"label": "C", "text": "Assertion (A) is false, but Reason (R) is true.", "correct": true}, {"label": "D", "text": "Both Assertion (A) and Reason (R) are false.", "correct": false}], "correct_answer": "C. Assertion (A) is false, but Reason (R) is true.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/SWvNs7MEQBTGXdwEbtJ41743940431.png", "https://image.prepladder.com/notes/XywOew8oD3hvqVGLSQ6M1743940460.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:717px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT (Computed Tomography)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI (Magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">Resonance</span> Imaging)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Principle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Based on <span class=\"customMeta\" data-dictid=\"6bd54dfc48169277718674cd08e586\">differential</span> <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> of <span class=\"customMeta\" data-dictid=\"6fda63a90c1692777202563d33a81b\">X-rays</span> by tissues (denser tissues absorb more X-rays)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Based on the <span class=\"customMeta\" data-dictid=\"3c0c325f4216927771819e5d0eb581\">alignment</span> of <span class=\"customMeta\" data-dictid=\"11f7bcb8da16927771898e93932195\">hydrogen</span> protons in tissues in response to a <span class=\"customMeta\" data-dictid=\"c731b7ca621692777191324e5d32e7\">magnetic field</span> and <span class=\"customMeta\" data-dictid=\"07f73f8986169277719716f3a62e1b\">radiofrequency</span> pulses</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Time</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Faster</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Slower, can take 30 minutes to over an hour</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Bone <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> appearance: </strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>White (due to dense bone absorbing X-rays)</p>\n<img alt=\"RA033\" data-author=\"\" data-hash=\"7794\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/SWvNs7MEQBTGXdwEbtJ41743940431.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dark (lacks <span class=\"customMeta\" data-dictid=\"11f7bcb8da16927771898e93932195\">hydrogen</span> protons)</p>\n<p><img alt=\"RA034\" data-author=\"\" data-hash=\"7795\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/XywOew8oD3hvqVGLSQ6M1743940460.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:140px\">\n<p><strong>Applications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:293px\">\n<p><strong>Best for:</strong> <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> bleeding, skull fractures, calcifications, <span class=\"customMeta\" data-dictid=\"c7c23b05e116927771899b5232b3d7\">hyperacute</span> stroke</p>\n<p><strong>Emergency use: </strong>Ideal for emergencies due to speed</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:284px\">\n<p><strong>Best for: </strong>Soft tissue details, brain tumors, demyelinating diseases, subacute/chronic ischemia</p>\n<p><strong>Emergency use: </strong>Not typically used in emergencies (except for soft tissue analysis)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:140px\">\n<p><strong>Detection of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> Hemorrhage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:293px\">\n<p>Highly sensitive for detecting <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> hemorrhage</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:284px\">\n<p>Less sensitive for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> hemorrhage, but can be used after a few days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:140px\">\n<p><strong>Evaluation of Edema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:293px\">\n<p>Limited sensitivity to subtle edema</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:284px\">\n<p>Excellent for detecting <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> and differentiating tissue types</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:140px\">\n<p><strong>Stroke Detection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:293px\">\n<p>Good for detecting stroke in <span class=\"customMeta\" data-dictid=\"c7c23b05e116927771899b5232b3d7\">hyperacute</span> phase (hours)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:284px\">\n<p>Better for detecting <span class=\"customMeta\" data-dictid=\"0f670d10711692777190af4b12fac9\">ischemia</span> in <span class=\"customMeta\" data-dictid=\"159e1426d61692777199d9361738d0\">subacute</span> and chronic stages (days to weeks)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:140px\">\n<p><strong>Contrast Agent Used</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:293px\">\n<p>Iodine-based contrast agents (risk of <span class=\"customMeta\" data-dictid=\"aa1288c36b16927771814fa5aa84eb\">allergy</span> or <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> issues)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:284px\">\n<p>Gadolinium-based contrast agents (caution in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure)</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:726px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>NCCT </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CECT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Contrast MRI</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CE-MRI (Contrast-Enhanced MRI)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiation Exposure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses <span class=\"customMeta\" data-dictid=\"059f32bb2b16927771907b928e012e\">ionizing radiation</span> (X-rays)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses <span class=\"customMeta\" data-dictid=\"059f32bb2b16927771907b928e012e\">ionizing radiation</span> (X-rays)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No radiation (uses magnetic fields)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No radiation (uses magnetic fields)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contrast Agent</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No <span class=\"customMeta\" data-dictid=\"dbe88a287916927771845c7b3aa937\">contrast agent</span> used</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Iodine-based <span class=\"customMeta\" data-dictid=\"dbe88a287916927771845c7b3aa937\">contrast agent</span> used</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No <span class=\"customMeta\" data-dictid=\"dbe88a287916927771845c7b3aa937\">contrast agent</span> used</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gadolinium-based <span class=\"customMeta\" data-dictid=\"dbe88a287916927771845c7b3aa937\">contrast agent</span> used</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Soft Tissue Resolution</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lower compared to MRI, useful for detecting <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> bleeds</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Better soft tissue contrast than NCCT due to contrast enhancement</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Excellent soft tissue resolution, ideal for detecting subtle changes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Excellent soft tissue resolution with better contrast for lesions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Applications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute stroke (to exclude hemorrhage), trauma, calcifications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tumor detection, infections, <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> abnormalities</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stroke (subacute/chronic), demyelinating diseases, tumors (no contrast)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tumors, infections, <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> lesions, better delineation of <span class=\"customMeta\" data-dictid=\"d89cb634601692777183adec401a59\">blood-brain barrier</span> disruptions</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:696px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Applications</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Contrast CT (NCCT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"bef027ba821692777190cb424e9554\">ischemic stroke</span> (to exclude hemorrhage)</li>\n<li>Intracranial hemorrhage</li>\n<li>Head trauma (skull fractures, brain injury)</li>\n<li>Hydrocephalus</li>\n<li>Calcifications (tumors, infections)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contrast-Enhanced CT (CECT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Brain tumors (primary and metastatic)</li>\n<li>Infections (abscesses, encephalitis)</li>\n<li>Vascular abnormalities (aneurysms, <span class=\"customMeta\" data-dictid=\"3c19af349e16927771825f314a4a84\">arteriovenous</span> malformations)</li>\n<li>Venous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>High-Resolution CT (HRCT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Detailed evaluation of brain <span class=\"customMeta\" data-dictid=\"e46d46c1521692777194d02f11f83b\">parenchyma</span> and skull base</li>\n<li>Assessment of bony structures (temporal bones, skull fractures)</li>\n<li>Evaluation of small vessel calcifications</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male with a significant history of smoking presents with a sudden onset of a severe headache. He reports accompanying symptoms of palpitations, photophobia, and neck stiffness. On examination, signs of meningeal irritation are noted. The patient also has hyperflexible joints and mentions that his symptoms began after experiencing a minor jerk while in the car. A CT scan reveals specific findings given below. What is the most likely cause of this patient's symptoms?", "options": [{"label": "A", "text": "Meningitis secondary to a bacterial infection", "correct": false}, {"label": "B", "text": "Cervical spine injury leading to meningeal irritation", "correct": false}, {"label": "C", "text": "Migraine with aura exacerbated by the minor jerk", "correct": false}, {"label": "D", "text": "Rupture of a cerebral aneurysm", "correct": true}], "correct_answer": "D. Rupture of a cerebral aneurysm", "question_images": ["https://image.prepladder.com/notes/qDInvXJo7QfEpjgyeOVF1743943264.png"], "explanation_images": ["https://image.prepladder.com/notes/qDInvXJo7QfEpjgyeOVF1743943264.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:690px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Presence of blood in the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space, typically from a ruptured cerebral <span class=\"customMeta\" data-dictid=\"f2c92eaffe16927771819978aa5666\">aneurysm</span> or trauma.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sudden, severe headache (often described as a \"thunderclap headache\")</li>\n<li>Worst headache ever experienced by the patient.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Traumatic: </strong>Head injuries causing <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> in the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space.</li>\n<li><strong>Non-Traumatic: </strong>Most commonly due to <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> of a cerebral aneurysm.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Initial Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Contrast CT (NCCT):</strong> First-line <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> for suspected SAH, effective in the <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> setting.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Radiological Findings (NCCT)</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Appearance of Blood:</strong> <span class=\"customMeta\" data-dictid=\"1dfb6906b91692777189e0acce4f86\">Hyperdense</span> (white) compared to surrounding <span class=\"customMeta\" data-dictid=\"99a9bf133e1692777184ec4b1011fe\">cerebrospinal</span> fluid (CSF).</p>\n\t\t\t \n\n\t\t\t<p>Common Sites for Blood Accumulation:</p>\n<ul>\n<li>Interhemispheric Fissure</li>\n<li>Sylvian Fissure</li>\n<li>Suprasellar Cistern</li>\n<li>Perimesencephalic Cistern</li>\n</ul>\n<p><br/>\n\t\t\tDistinctive Shape: Blood may take on a pentagon or star shape, <span class=\"customMeta\" data-dictid=\"047f8930dd1692777197fed61e213c\">referred</span> to as the \"<strong>Star of Death.\"</strong></p>\n<img alt=\"RA063\" data-author=\"\" data-hash=\"7823\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/qDInvXJo7QfEpjgyeOVF1743943264.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:163px\">\n<p><strong>Additional Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:527px\">\n<p><strong>CT Angiography:</strong> Visualizes potential aneurysms or <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> malformations; useful for <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> suspicion.</p>\n<p><strong>Digital <span class=\"customMeta\" data-dictid=\"408be3f8d81692777199619278702d\">Subtraction</span> <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (DSA):</strong> Gold standard for diagnosing cerebral aneurysms; provides detailed <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> images and <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> options (e.g., <span class=\"customMeta\" data-dictid=\"0dc32a9edf1692777187a82b199252\">endovascular</span> coiling).</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male presents after a road traffic accident. He experienced a brief loss of consciousness, followed by a lucid interval. On examination, he has a Glasgow Coma Scale score of 13 and exhibits signs of a head injury. A CT scan of the head was performed, and the image revealed the following findings. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Subdural hematoma (SDH)", "correct": false}, {"label": "B", "text": "Epidural hematoma (EDH)", "correct": true}, {"label": "C", "text": "Subarachnoid hemorrhage (SAH)", "correct": false}, {"label": "D", "text": "Cerebral contusion", "correct": false}], "correct_answer": "B. Epidural hematoma (EDH)", "question_images": ["https://image.prepladder.com/notes/rYxgpyGzLTFgvaTujNXi1743943000.png"], "explanation_images": ["https://image.prepladder.com/notes/4Wip1p7oSSGJlXdEhXc81743943055.png", "https://image.prepladder.com/notes/8pL4D4VlT5kGxLua9eQU1743943113.png", "https://image.prepladder.com/notes/a3KzpbpXIUTJuCcf9cTT1743943151.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:722px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Extradural <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">Hemorrhage</span> (EDH)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subdural <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">Hemorrhage</span> (SDH) </strong><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Hemorrhage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Arterial Hemorrhage</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Venous Hemorrhage</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Shape</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Biconvex or lentiform</p>\n<p><img alt=\"RA061\" data-author=\"\" data-hash=\"7821\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/8pL4D4VlT5kGxLua9eQU1743943113.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Crescent or sickle-shaped</p>\n<p><img alt=\"RA062\" data-author=\"\" data-hash=\"7822\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/a3KzpbpXIUTJuCcf9cTT1743943151.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:156px\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:275px\">\n<p>Limited by sutures; can cross the midline</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:291px\">\n<p>Follows the brain surface; crosses sutures, does not cross midline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:156px\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:275px\">\n<p>Rupture of the middle meningeal <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (MMA)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:291px\">\n<p>Rupture of <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> <span class=\"customMeta\" data-dictid=\"ec4db08de51692777183e82739c83d\">bridging</span> veins</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:156px\">\n<p><strong>Onset of Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:275px\">\n<p>Often presents with a <span class=\"customMeta\" data-dictid=\"10b50278251692777191a626ee1604\">lucid</span> interval</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:291px\">\n<p>Symptoms may develop gradually, often without a <span class=\"customMeta\" data-dictid=\"10b50278251692777191a626ee1604\">lucid</span> interval</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:156px\">\n<p><strong>Force Required</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:275px\">\n<p>Requires more force; associated with adjacent bony rupture</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:291px\">\n<p>Can occur with trivial trauma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:156px\">\n<p><strong>Midline Crossing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:275px\">\n<p>Can cross the midline</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:291px\">\n<p>Does not cross the midline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:156px\">\n<p><strong>Lucid Interval</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:275px\">\n<p>Yes; patient appears normal before deterioration</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:291px\">\n<p>No; deterioration may be more gradual</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:156px\">\n<p><strong>Clinical Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:275px\">\n<p>Symptoms may include headache, loss of consciousness, and <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> neurological deficits</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:291px\">\n<p>Symptoms may include headache, confusion, and potential <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> deficits</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/d1vpAHsJ7e6LQ2lpzqXu1746429390.mp3", "video": ""}, {"text": "A 28-year-old male presents to the emergency department following a head injury sustained during a fall. He is alert, opens his eyes to speech, follows commands, and is oriented but complains of a mild headache. On assessment, he opens his eyes spontaneously, is verbally coherent but slightly disoriented, and follows motor commands. There are no focal neurological deficits, bleeding disorders, seizures, or intoxication. Based on the clinical findings and his GCS score, what is the next appropriate step in management?", "options": [{"label": "A", "text": "Immediate intubation and mechanical ventilation", "correct": false}, {"label": "B", "text": "CT scan of the head", "correct": false}, {"label": "C", "text": "Observation with repeat neurological assessment every 4 hours", "correct": true}, {"label": "D", "text": "Initiate anticonvulsant therapy", "correct": false}], "correct_answer": "C. Observation with repeat neurological assessment every 4 hours", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:477px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>GCS Score</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TBI Severity</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>13-15</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild TBI</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>9-12</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate TBI</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3-8</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe TBI</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient comes with his MR angiography brain report to the clinic. Identify the marked artery in this image.", "options": [{"label": "A", "text": "Anterior cerebral artery", "correct": false}, {"label": "B", "text": "Vertebral artery", "correct": false}, {"label": "C", "text": "Basilar artery", "correct": true}, {"label": "D", "text": "Middle cerebral artery", "correct": false}], "correct_answer": "C. Basilar artery", "question_images": ["https://image.prepladder.com/notes/M9K0GZ5ewWOwmZTpm6Dz1743942790.png"], "explanation_images": ["https://image.prepladder.com/notes/x3fN7BHtgb5bADSIkDXq1743942860.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">Resonance</span> <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (MRA)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>There are various types of MR angiograms based on different principles and can be classified into non-contrast and contrast enhanced methods.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-contrast MRA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contrast enhanced (CE) MRA</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Time-of-flight (TOF) imaging: </strong></p>\n<ul>\n<li>It is the <strong>most prevalent method </strong>for Magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">Resonance</span> <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (MRA) in clinical practice.</li>\n</ul>\n<p><strong>Phase-contrast MRA:</strong></p>\n<ul>\n<li>It is more sensitive for <strong>identifying slow <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> </strong>and useful for <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> cerebral veins (MR <span class=\"customMeta\" data-dictid=\"8a7362882e1692777201ef793c3fd4\">venography</span> or MRV).</li>\n<li>Effective for detecting <strong>dural <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">thrombosis</span> </strong>and <strong>venous stenoses.</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>MRA combined with<strong> gadolinium-based contrast agents</strong> is called contrast-enhanced (CE) MRA.<br/>\n\t\t\t\t </li>\n<li>Excellent for quickly visualizing the <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> and vertebral arteries where a large field of view (FOV) is necessary.<br/>\n\t\t\t\t </li>\n<li>Reduces artifacts caused by turbulent or slow flow.<br/>\n\t\t\t\t </li>\n<li>Useful for assessing <strong>arteriovenous malformations </strong>(AVMs), <strong>aneurysms</strong>, and <strong>intracranial stenosis</strong>.</li>\n<li>Two types are:\n\t\t\t\t<ul>\n<li>Elliptical-centric</li>\n<li>Multiphase techniques</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><img alt=\"RA058\" data-author=\"\" data-hash=\"7818\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/x3fN7BHtgb5bADSIkDXq1743942860.png\"/></td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements about the given image is not true?", "options": [{"label": "A", "text": "It is a standard investigation alongside non-contrast CT for diagnosing stroke", "correct": true}, {"label": "B", "text": "It is used to resolve discrepancies in findings from noninvasive imaging", "correct": false}, {"label": "C", "text": "It diagnoses spontaneous subarachnoid hemorrhage when CTA results are negative", "correct": false}, {"label": "D", "text": "It can be used for embolization of AVMs and fistulas", "correct": false}], "correct_answer": "A. It is a standard investigation alongside non-contrast CT for diagnosing stroke", "question_images": ["https://image.prepladder.com/notes/KWX2YmTOfIxg2rMMuHBp1743942585.png"], "explanation_images": ["https://image.prepladder.com/notes/MyG5BwcyyjXg2O8xpgPQ1743942638.png", "https://image.prepladder.com/notes/ciSfYgTnK64rzFwEYffS1743942681.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Computed <span class=\"customMeta\" data-dictid=\"8d4f2a375b1692777200f41db641bc\">Tomography</span> <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (CTA)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical applications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Acute stroke protocols</strong>: <span class=\"customMeta\" data-dictid=\"bc458970271692777185723e3ace49\">CTA</span> is a standard investigation alongside non-contrast CT and CT <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> (CTP) for evaluating stroke.</li>\n<li>It is used to detect dynamic contrast <span class=\"customMeta\" data-dictid=\"f0c6fefae41692777187c76a6f65f6\">extravasation</span> indicative of <strong>active hemorrhage</strong>.</li>\n<li>It is highly sensitive (&gt;90%) for<strong> <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> aneurysms</strong>, particularly in <strong>subarachnoid <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> </strong>cases.</li>\n<li>It is also effective for assessing <strong>carotid <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> stenosis</strong>, <strong>cervical <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> dissection</strong>, and <strong>intracranial <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> stenosis</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Digital <span class=\"customMeta\" data-dictid=\"408be3f8d81692777199619278702d\">Subtraction</span> <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (DSA)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Applications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Resolve discrepancies in findings from noninvasive <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> (CTA or MRA). <strong>(Option B)</strong></li>\n<li>Diagnosing <span class=\"customMeta\" data-dictid=\"f71e485d131692777199151d1076d2\">spontaneous</span> <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> when <span class=\"customMeta\" data-dictid=\"bc458970271692777185723e3ace49\">CTA</span> results are negative. <strong>(Option C)</strong></li>\n<li>Evaluate younger patients with intraparenchymal <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> for underlying <span class=\"customMeta\" data-dictid=\"3c19af349e16927771825f314a4a84\">arteriovenous</span> malformations (AVMs).</li>\n<li>DSA supports a variety of <span class=\"customMeta\" data-dictid=\"0dc32a9edf1692777187a82b199252\">endovascular</span> treatments, including:\n\t\t\t\t<ul>\n<li><strong>Clot <span class=\"customMeta\" data-dictid=\"cbe99c8c751692777197bc9fcb503b\">retrieval</span> </strong>for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> ischemic stroke</li>\n<li>Treatment of<strong> brain aneurysms</strong> (coiling, stenting, flow diversion)</li>\n<li><strong>Embolization </strong>of <strong>AVMs </strong>and <strong>fistulas </strong> <strong>(Option D)</strong></li>\n<li><strong>Tumor <span class=\"customMeta\" data-dictid=\"27e516f8fe16927771876f99c6b831\">embolization</span> </strong>and <strong>stenting </strong>of <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> arterial stenoses</li>\n<li>Intra-arterial therapies for <strong>vasospasm</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"RA055\" data-author=\"\" data-hash=\"7815\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/MyG5BwcyyjXg2O8xpgPQ1743942638.png\"/></p>\n<img alt=\"RA056\" data-author=\"\" data-hash=\"7816\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ciSfYgTnK64rzFwEYffS1743942681.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following structures with their corresponding CT score. Structure CT score in HU a) Air 1) 0 b) Water 2) -1000 c) Grey Matter 3) 700 to 3000 d) Bone 4) 37 to 45", "options": [{"label": "A", "text": "a-2, b-1, c-4, d-3", "correct": true}, {"label": "B", "text": "a-1, b-2, c-3, d-4", "correct": false}, {"label": "C", "text": "a-2, b-3, c-1, d-4", "correct": false}, {"label": "D", "text": "a-1, b-4, c-2, d-3", "correct": false}], "correct_answer": "A. a-2, b-1, c-4, d-3", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:308px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Structure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT score in HU</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>a) Air</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1) -1000</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>b) Water</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2) 0</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>c) Grey Matter</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3) 37 to 45</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>d) Bone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4) 700 to 3000</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:352px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Structure </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT score (HU)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Air</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-1000</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Water</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CSF</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>8 to 15</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>White matter</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>20 to 30</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blood</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>30 to 45</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Grey matter</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>37 to 45</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contrast</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100 to 300</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>700 (cancellous) to 3000 (inner and outer tables)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/a09A70rc7KymF3mSP3Oc1747840845.mp3", "video": ""}, {"text": "A student is analyzing an MRI of the brain at the midbrain level. The examiner asks the student to identify the structure marked as âaâ. What is this structure?", "options": [{"label": "A", "text": "Optic tract", "correct": false}, {"label": "B", "text": "Amygdala", "correct": false}, {"label": "C", "text": "Mamillary body", "correct": false}, {"label": "D", "text": "Anterior cerebral artery", "correct": true}], "correct_answer": "D. Anterior cerebral artery", "question_images": ["https://image.prepladder.com/notes/ngV2LN3JIn7tq5vm9Huo1743941443.png"], "explanation_images": ["https://image.prepladder.com/notes/xevAFKH0wNXHNkLSxYHZ1743941524.png", "https://image.prepladder.com/notes/6Cx57Wg1LPvhmA0g3TSA1743942271.png", "https://image.prepladder.com/notes/xTYAzVZX4d9zLjHhIMRB1743942396.png", "https://image.prepladder.com/notes/993L80RVMOk0imHScocc1743942436.png", "https://image.prepladder.com/notes/dJusLR3gnFdr0aZHE96i1743941585.png", "https://image.prepladder.com/notes/UaPDOe4PZzNcwogKycrH1743942330.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>MRI BRAIN </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>CT BRAIN </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>This uses the <span class=\"customMeta\" data-dictid=\"3c0c325f4216927771819e5d0eb581\">alignment</span> of <span class=\"customMeta\" data-dictid=\"11f7bcb8da16927771898e93932195\">hydrogen</span> protons in tissues in response to a <span class=\"customMeta\" data-dictid=\"c731b7ca621692777191324e5d32e7\">magnetic field</span> and <span class=\"customMeta\" data-dictid=\"07f73f8986169277719716f3a62e1b\">radiofrequency</span> pulses.</li>\n<li>The skull bone <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> appears black/dark in the MRI.</li>\n</ul>\n<p><img alt=\"RA047\" data-author=\"\" data-hash=\"7808\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/xevAFKH0wNXHNkLSxYHZ1743941524.png\"/></p>\n<p><img alt=\"RA049\" data-author=\"\" data-hash=\"7810\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/6Cx57Wg1LPvhmA0g3TSA1743942271.png\"/></p>\n<p><img alt=\"RA051\" data-author=\"\" data-hash=\"7812\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/xTYAzVZX4d9zLjHhIMRB1743942396.png\"/></p>\n<p><img alt=\"RA052\" data-author=\"\" data-hash=\"7813\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/993L80RVMOk0imHScocc1743942436.png\"/></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>X-rays that penetrate the head or other parts of the body produce images based on tissue density and atomic number.</li>\n<li>The bone <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> can be seen as a <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> (white) area.</li>\n</ul>\n<p><img alt=\"RA048\" data-author=\"\" data-hash=\"7809\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/dJusLR3gnFdr0aZHE96i1743941585.png\"/></p>\n<p><img alt=\"RA050\" data-author=\"\" data-hash=\"7811\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/UaPDOe4PZzNcwogKycrH1743942330.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 58-year-old male presents with persistent headaches and cognitive decline. An MRI reveals a suspicious mass in the parietal lobe. To further characterize the mass, an MR spectroscopy (MRS) is performed which shows: Which of the following interpretations is most accurate regarding the metabolic changes observed in MR spectroscopy?", "options": [{"label": "A", "text": "The elevated choline levels suggest high cellular turnover", "correct": true}, {"label": "B", "text": "The decreased NAA indicates significant neuronal viability", "correct": false}, {"label": "C", "text": "The absence of any metabolites in the spectrum indicates healthy brain tissue", "correct": false}, {"label": "D", "text": "Raised creatinine levels show low metabolic activity", "correct": false}], "correct_answer": "A. The elevated choline levels suggest high cellular turnover", "question_images": ["https://image.prepladder.com/notes/6YDmQZCLbcCRWqlRdpTC1743941253.png"], "explanation_images": ["https://image.prepladder.com/notes/7BtVqNAWSA1Vq8em2UDK1743941312.png"], "explanation": "<p><strong>References:</strong></p>\n<ul><li>âł MR Spectroscopy</li><li>âł MR Spectroscopy</li><li>âł MR Spectroscopy</li><li>âł MR Spectroscopy</li><li>âł It is a technique used to analyze metabolites in various tissues, including the brain, breast, and prostate done at 1.5 or 3T. Measures levels of lactate, lipids, and choline within a specific volume of tissues.</li><li>âł It is a technique used to analyze metabolites in various tissues, including the brain, breast, and prostate done at 1.5 or 3T. Measures levels of lactate, lipids, and choline within a specific volume of tissues.</li><li>âł It is a technique used to analyze metabolites in various tissues, including the brain, breast, and prostate done at 1.5 or 3T. Measures levels of lactate, lipids, and choline within a specific volume of tissues.</li><li>âł It is a technique used to analyze metabolites in various tissues, including the brain, breast, and prostate done at 1.5 or 3T.</li><li>âł metabolites</li><li>âł brain, breast, and prostate</li><li>âł Measures levels of lactate, lipids, and choline within a specific volume of tissues.</li><li>âł lactate, lipids, and choline</li><li>âł Metabolite Markers N-acetyl aspartate (NAA) : indicates neuronal viability. (Option B) Choline : represents cell membrane composition and cellular turnover . Creatine : found in metabolically active tissues, serving as a reference. (Option D) Lipids : released during cell membrane damage. Lactate : signifies anaerobic metabolism. In a normal brain, these metabolites are present in the order: NAA &gt; creatinine &gt; choline. (Option C)</li><li>âł Metabolite Markers</li><li>âł Metabolite Markers</li><li>âł Metabolite Markers</li><li>âł N-acetyl aspartate (NAA) : indicates neuronal viability. (Option B) Choline : represents cell membrane composition and cellular turnover . Creatine : found in metabolically active tissues, serving as a reference. (Option D) Lipids : released during cell membrane damage. Lactate : signifies anaerobic metabolism. In a normal brain, these metabolites are present in the order: NAA &gt; creatinine &gt; choline. (Option C)</li><li>âł N-acetyl aspartate (NAA) : indicates neuronal viability. (Option B) Choline : represents cell membrane composition and cellular turnover . Creatine : found in metabolically active tissues, serving as a reference. (Option D) Lipids : released during cell membrane damage. Lactate : signifies anaerobic metabolism. In a normal brain, these metabolites are present in the order: NAA &gt; creatinine &gt; choline. (Option C)</li><li>âł N-acetyl aspartate (NAA) : indicates neuronal viability. (Option B)</li><li>âł N-acetyl aspartate (NAA)</li><li>âł (Option B)</li><li>âł Choline : represents cell membrane composition and cellular turnover .</li><li>âł Choline</li><li>âł cellular turnover</li><li>âł Creatine : found in metabolically active tissues, serving as a reference. (Option D)</li><li>âł Creatine</li><li>âł (Option D)</li><li>âł Lipids : released during cell membrane damage.</li><li>âł Lipids</li><li>âł Lactate : signifies anaerobic metabolism.</li><li>âł Lactate</li><li>âł In a normal brain, these metabolites are present in the order: NAA &gt; creatinine &gt; choline. (Option C)</li><li>âł NAA &gt; creatinine &gt; choline.</li><li>âł (Option C)</li><li>âł Clinical Applications Choline is raised in malignancies. Lipids are raised in TB due to mycolipids of mycobacterium. MRS is used for assessing brain tumors, including: Grading of tumors. Monitoring tumor progression versus treatment effects. Diagnosing infectious and metabolic diseases.</li><li>âł Clinical Applications</li><li>âł Clinical Applications</li><li>âł Clinical Applications</li><li>âł Choline is raised in malignancies. Lipids are raised in TB due to mycolipids of mycobacterium. MRS is used for assessing brain tumors, including: Grading of tumors. Monitoring tumor progression versus treatment effects. Diagnosing infectious and metabolic diseases.</li><li>âł Choline is raised in malignancies. Lipids are raised in TB due to mycolipids of mycobacterium. MRS is used for assessing brain tumors, including: Grading of tumors. Monitoring tumor progression versus treatment effects. Diagnosing infectious and metabolic diseases.</li><li>âł Choline is raised in malignancies.</li><li>âł Lipids are raised in TB due to mycolipids of mycobacterium.</li><li>âł MRS is used for assessing brain tumors, including: Grading of tumors. Monitoring tumor progression versus treatment effects. Diagnosing infectious and metabolic diseases.</li><li>âł Grading of tumors. Monitoring tumor progression versus treatment effects. Diagnosing infectious and metabolic diseases.</li><li>âł Grading of tumors.</li><li>âł Monitoring tumor progression versus treatment effects.</li><li>âł Diagnosing infectious and metabolic diseases.</li></ul>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MR Spectroscopy</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is a technique used to analyze <strong>metabolites </strong>in various tissues, including the<strong> brain, breast, and prostate</strong> done at 1.5 or 3T.</li>\n<li>Measures levels of<strong> lactate, lipids, and <span class=\"customMeta\" data-dictid=\"ad6984dc581692777184936c84dd97\">choline</span> </strong>within a specific volume of tissues.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolite Markers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>N-acetyl <span class=\"customMeta\" data-dictid=\"3d988dbcc816927771821e9a2544f7\">aspartate</span> (NAA)</strong>: indicates neuronal viability. <strong>(Option B)</strong></li>\n<li><strong>Choline</strong>: represents cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> composition and<strong> <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">cellular</span> turnover</strong>.</li>\n<li><strong>Creatine</strong>: found in metabolically active tissues, serving as a reference. <strong>(Option D)</strong></li>\n<li><strong>Lipids</strong>: released during cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> damage.</li>\n<li><strong>Lactate</strong>: signifies <span class=\"customMeta\" data-dictid=\"4880fc99551692777181e25a64560f\">anaerobic</span> metabolism.</li>\n<li>In a normal brain, these metabolites are present in the order: <strong>NAA &gt; <span class=\"customMeta\" data-dictid=\"2ead0fd0301692777185187bd72768\">creatinine</span> &gt; choline. </strong><strong>(Option C)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Applications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Choline is raised in malignancies.</li>\n<li>Lipids are raised in TB due to mycolipids of mycobacterium.</li>\n<li>MRS is used for assessing brain tumors, including:\n\t\t\t\t<ul>\n<li>Grading of tumors.</li>\n<li>Monitoring tumor <span class=\"customMeta\" data-dictid=\"3c305b384216927771969ca4166493\">progression</span> versus treatment effects.</li>\n<li>Diagnosing <span class=\"customMeta\" data-dictid=\"aa279cf1f016927771903f195bb1b9\">infectious</span> and <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> diseases.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male with progressive memory loss and word-finding difficulty shows language deficits on a neurological exam. The physician orders an MRI to map language centers before treatment. Which MRI technique is most appropriate for this?", "options": [{"label": "A", "text": "Diffuse Tensor Imaging", "correct": false}, {"label": "B", "text": "Susceptibility Weighted Imaging", "correct": false}, {"label": "C", "text": "Functional MRI", "correct": true}, {"label": "D", "text": "Perfusion Weighted Imaging", "correct": false}], "correct_answer": "C. Functional MRI", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/owqDLiDt4PE2flSRxy3e1743940960.png", "https://image.prepladder.com/notes/ZNtV9ufmX4ClNqgEFFi71743940998.png", "https://image.prepladder.com/notes/gU9BjoKD3F5DlJEcLW641743941050.png", "https://image.prepladder.com/notes/9Is41tNy7Wo1JbjJovxs1743941105.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Functional <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> (fMRI)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is used for noninvasive <span class=\"customMeta\" data-dictid=\"efa5d21d3d16927771918a62baf918\">mapping</span> of<strong> brain function related to specific tasks</strong> (e.g., motor, language, visual, memory).</li>\n<li>It provides insights into<strong> functional localization, <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> variations,</strong> and the effects of <strong>diseases and adaptations</strong> and is important for<strong> <span class=\"customMeta\" data-dictid=\"e76ccaf0af1692777196a34b3fb8dc\">preoperative</span> assessments</strong> in tumors, <span class=\"customMeta\" data-dictid=\"3c19af349e16927771825f314a4a84\">arteriovenous</span> malformations (AVMs), and <span class=\"customMeta\" data-dictid=\"7546d26cea1692777187c257d4e14c\">epilepsy</span> surgery.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Principle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Increased <span class=\"customMeta\" data-dictid=\"b00388be25169277719369b3ab059f\">neural</span> activity during a task</p>\n<p style=\"text-align:center\"><strong>ￏ</strong></p>\n<p style=\"text-align:center\">Localized rise in <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> for oxygen and <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> supply</p>\n<p style=\"text-align:center\"><strong>ￏ</strong></p>\n<p style=\"text-align:center\"><strong>￪ </strong>Oxygenated <span class=\"customMeta\" data-dictid=\"ad2073fe6716927771885f3c1ec652\">hemoglobin</span> (oxyHb)</p>\n<p style=\"text-align:center\"><strong>ￏ</strong>deoxygenated <span class=\"customMeta\" data-dictid=\"ad2073fe6716927771885f3c1ec652\">hemoglobin</span> (deoxyHb)</p>\n<p style=\"text-align:center\"><strong>ￏ</strong></p>\n<p style=\"text-align:center\">Changes in magnetization</p>\n<p style=\"text-align:center\"><strong>ￏ</strong></p>\n<p style=\"text-align:center\">Measured by <strong>blood oxygen level-dependent (BOLD) effect</strong>.</p>\n\t\t\t \n\n\t\t\t<ul>\n<li>The comparison between the BOLD effect measured at rest and while doing a particular function gives the<strong> precise functional <span class=\"customMeta\" data-dictid=\"e485bb67f81692777191dfee6366cc\">localization</span> of nerve cells</strong> to be <strong>color-mapped</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Applications </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Detects functionality in diseases like Alzheimerâs.</li>\n<li>Presurgical assessment for brain tumor and AVM surgeries.</li>\n<li>Preepilepsy surgery assessment of language <span class=\"customMeta\" data-dictid=\"1feb2a0a3016927771847db9449f75\">centre</span> <span class=\"customMeta\" data-dictid=\"e485bb67f81692777191dfee6366cc\">localization</span> and hemispheric dominance.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:650px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Susceptibility- Weighted <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> (SWI) </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It incorporates T2*-signal intensity losses in images.</li>\n<li>This is highly sensitive for detecting variations in tissue structure caused by differences in susceptibility.</li>\n<li>Effectively<strong> identifies substances</strong> such as\n\t\t\t\t<ul>\n<li><strong>Deoxygenated blood</strong></li>\n<li><strong>Hemosiderin</strong></li>\n<li><strong>Ferritin</strong></li>\n<li><strong>Calcium</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T2*</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>T2* (T2 star) <span class=\"customMeta\" data-dictid=\"5bc49d94df16927771975eae86de9f\">relaxation</span> is the time taken for the <span class=\"customMeta\" data-dictid=\"6a867651ba1692777185bb15ba2f9c\">decay</span> of <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> <span class=\"customMeta\" data-dictid=\"06f6ec6c331692777191cbe09a6122\">magnetization</span> in magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">resonance</span> <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> (MRI), including both the <span class=\"customMeta\" data-dictid=\"ee77d507701692777190bfcf47b497\">irreversible</span> T2 <span class=\"customMeta\" data-dictid=\"5bc49d94df16927771975eae86de9f\">relaxation</span> and additional <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> dephasing processes.</li>\n<li>T2* is always less than T2.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA043\" data-author=\"\" data-hash=\"7804\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/9Is41tNy7Wo1JbjJovxs1743941105.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old man is brought to the emergency department with a sudden onset of weakness for an hour on one side of his body. He has a history of deep vein thrombosis but is not compliant with his medications. A CT scan is performed, which shows no acute hemorrhage. An MRI of the brain was performed below. Which MRI sequence is most appropriate for detecting early ischemic changes in this patient?", "options": [{"label": "A", "text": "T1 weighted", "correct": false}, {"label": "B", "text": "Fluid-attenuated inversion recovery", "correct": false}, {"label": "C", "text": "T2 weighted", "correct": false}, {"label": "D", "text": "Diffusion-weighted imaging", "correct": true}], "correct_answer": "D. Diffusion-weighted imaging", "question_images": ["https://image.prepladder.com/notes/ZOX2KlADqMSyEFFy8VxN1743940666.png"], "explanation_images": ["https://image.prepladder.com/notes/x6pq9VwPPKWHUpTNXCd81743940733.png", "https://image.prepladder.com/notes/C6qhV56NyZ2X13uAKzzq1743940778.png", "https://image.prepladder.com/notes/vAOgSWJoZ7P9OBrKK10F1743940829.png", "https://image.prepladder.com/notes/ogC8y49wv1O1kSRTEZrT1743940871.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Principle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>When the patient is placed in an <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> machine, the <strong>protons </strong>in the body arrange themselves in a specific fashion, that is, <span class=\"customMeta\" data-dictid=\"635a7ea50e16927771944f08f17aed\">parallel</span> or <span class=\"customMeta\" data-dictid=\"18ee26e04f169277718163ce592dc9\">antiparallel</span> to the external <span class=\"customMeta\" data-dictid=\"c731b7ca621692777191324e5d32e7\">magnetic field</span> <strong>(Bâ)</strong>.</li>\n<li>When <strong>radiofrequency (FR) waves</strong> are passed through the patient, they induce the MR coil/antenna, which is digitally processed into images.</li>\n<li>The time between each RF pulse is called the <strong>repetition time (TR).</strong></li>\n<li>The time taken between the <span class=\"customMeta\" data-dictid=\"8265e091151692777187f264d73f3b\">excitation</span> of protons to the reading of an echo signal is called<strong> echo time (TE)</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contraindications </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Absolute:\n\t\t\t\t<ul>\n<li>Cardiac pacemaker</li>\n<li>Cochlear implants</li>\n<li>Aneurysmal clips</li>\n</ul>\n</li>\n<li>Relative:\n\t\t\t\t<ul>\n<li>Claustrophobia</li>\n<li>Tattoos</li>\n<li>Recent metal implants &amp; prosthetics</li>\n<li>Dental implants</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:697px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T1 weighted <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T2 weighted <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> </strong><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"RA036\" data-author=\"\" data-hash=\"7797\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/x6pq9VwPPKWHUpTNXCd81743940733.png\"/></p>\n<ul>\n<li>T1 is the time taken for the <span class=\"customMeta\" data-dictid=\"7ba18aa5e616927771918a45051a40\">longitudinal</span> <span class=\"customMeta\" data-dictid=\"06f6ec6c331692777191cbe09a6122\">magnetization</span> to return to 63% of its original value.</li>\n</ul>\n<p><strong>Observations: </strong></p>\n<ul>\n<li>Hyperintense:\n\t\t\t\t<ul>\n<li><strong>White matter is more intense than gray matter</strong></li>\n<li>Fat appears bright</li>\n<li>Cerebrospinal fluid is of low-intensity</li>\n</ul>\n</li>\n<li>Hypointense:\n\t\t\t\t<ul>\n<li>Melanin</li>\n<li>Proteinaceous material</li>\n<li>Gadolinium-based contrast agents</li>\n<li>Late <span class=\"customMeta\" data-dictid=\"159e1426d61692777199d9361738d0\">subacute</span> hemorrhage</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"RA037\" data-author=\"\" data-hash=\"7798\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/C6qhV56NyZ2X13uAKzzq1743940778.png\"/></p>\n<ul>\n<li>T2 is the time taken for the <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> <span class=\"customMeta\" data-dictid=\"06f6ec6c331692777191cbe09a6122\">magnetization</span> to <span class=\"customMeta\" data-dictid=\"6a867651ba1692777185bb15ba2f9c\">decay</span> to 37% of its original value.</li>\n</ul>\n<p><strong>Observations:</strong></p>\n<ul>\n<li>Hyperintense:\n\t\t\t\t<ul>\n<li>Cerebrospinal fluid</li>\n<li>Pathologies involving increased tissue water content</li>\n</ul>\n</li>\n<li>Hypointense:\n\t\t\t\t<ul>\n<li><strong>White matter is <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> compared to gray matter</strong></li>\n<li>Fat</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:376px\">\n<ul>\n<li>It has a short TR and TE</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:321px\">\n<ul>\n<li>It has a long TR and TE </li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"text-align:center\"><strong>Newer technologies in MRI</strong></td>\n</tr>\n<tr>\n<td>\n<p><strong>Diffusion-Weighted <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> (DWI)</strong></p>\n<p><img alt=\"RA038\" data-author=\"\" data-hash=\"7799\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"338\" src=\"https://image.prepladder.com/notes/vAOgSWJoZ7P9OBrKK10F1743940829.png\" width=\"300\"/></p>\n</td>\n<td>\n<ul>\n<li>Any <span class=\"customMeta\" data-dictid=\"54e0888a6616927771945a99208287\">pathology</span> that affects the <span class=\"customMeta\" data-dictid=\"aff8304142169277718661b3b8980a\">dispersion</span> of water is detected by this method.</li>\n<li>The shift of <span class=\"customMeta\" data-dictid=\"ba366417791692777187229d34e597\">extracellular</span> fluid into the <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> space causes restricted <strong>Brownian motion </strong>and gets detected as restricted <span class=\"customMeta\" data-dictid=\"9c760dcb641692777186f4cda5dc95\">diffusion</span> in the DWI.</li>\n<li>The skull is not visualized in this method.</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Applications: </strong></p>\n<ul>\n<li>Acute brain infarction:\n\t\t\t\t<ul>\n<li>The failure of the sodium-potassium <span class=\"customMeta\" data-dictid=\"5abb3a7e7f1692777182a8f4c42522\">ATP</span> pump leads to cytotoxic edema.</li>\n<li>Detected within <strong>minutes of onset</strong>.</li>\n</ul>\n</li>\n<li>Ischemia is seen as a bright lesion.</li>\n<li>Regions of active demyelination.</li>\n<li>Infections like cerebral abscess.</li>\n<li>Cellular tumors like <span class=\"customMeta\" data-dictid=\"c9b2c1943e1692777188917d65bd7e\">glioblastoma</span> and lymphoma.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Fluid-Attenuated <span class=\"customMeta\" data-dictid=\"94fdb58dbf16927771904508108f50\">Inversion</span> Recovery (FLAIR) </strong><strong>(Option B)</strong></p>\n<p><img alt=\"RA039\" data-author=\"\" data-hash=\"7800\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"377\" src=\"https://image.prepladder.com/notes/ogC8y49wv1O1kSRTEZrT1743940871.png\" width=\"300\"/></p>\n</td>\n<td>\n<ul>\n<li>This is useful in identifying:\n\t\t\t\t<ul>\n<li>Demyelinating plaques</li>\n<li>Edema</li>\n<li>Infarcts after 6 hours</li>\n<li>Differentiation of <span class=\"customMeta\" data-dictid=\"dd3534c97c16927771823c0d04f685\">arachnoid</span> <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> from other complex cysts</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Hyperintensity may be seen in cerebral or cerebellar <span class=\"customMeta\" data-dictid=\"666497f9c41692777199edd6cd1884\">sulci</span> due to:\n\t\t\t\t<ul>\n<li>Blood product in <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> hemorrhage</li>\n<li>Pus in meningitis</li>\n<li>Leptomeningeal spread of tumor</li>\n<li>Artefact due to oxygen administration during the scanning.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 32 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "An intern reviewing an MRI scan observes a \"boxcar ventricleâ This radiological finding is indicative of which of the following conditions?", "options": [{"label": "A", "text": "Creutzfeldt-Jakob disease", "correct": false}, {"label": "B", "text": "Huntington's disease", "correct": true}, {"label": "C", "text": "Pick's disease", "correct": false}, {"label": "D", "text": "Alzheimerâs disease", "correct": false}], "correct_answer": "B. Huntington's disease", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/7hPo6TM042dCzPAqHn1s1744187078.png", "https://image.prepladder.com/notes/uNMlOZ7Q5A570SYC9ojW1744187078.png", "https://image.prepladder.com/notes/ZrfLSYMVFjSAluLLktq11744187079.png", "https://image.prepladder.com/notes/nOhzUnp0JFVCT3VJ24kk1744187079.png", "https://image.prepladder.com/notes/un6NKQEoSddwyppXlY5Q1744187080.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hereditary neurodegenerative disorder characterized by chorea, psychiatric symptoms, and cognitive decline.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inheritance Pattern</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Autosomal dominant due to a <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> in the HTT gene on <span class=\"customMeta\" data-dictid=\"7157c1f59916927771846116d74646\">chromosome</span> 4 involving a CAG <span class=\"customMeta\" data-dictid=\"74dd17aa171692777200dcc186c177\">trinucleotide</span> repeat.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chorea: </strong>Involuntary, <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> movements.</p>\n<p><strong>Mood Changes:</strong> <span class=\"customMeta\" data-dictid=\"982688ae75169277719041afa70c42\">Irritability</span> and aggressive behavior.</p>\n<p><strong>Cognitive Decline:</strong> Progressive memory loss (dementia).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Radiological Findings</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atrophy of <span class=\"customMeta\" data-dictid=\"1d14ed8c1216927771832ccea0c79f\">Caudate</span> Nucleus: Leads to <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">dilation</span> of the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> horn of the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> ventricle.</p>\n<p>\"Boxcar Ventricles\" Appearance: Resulting from <span class=\"customMeta\" data-dictid=\"1d14ed8c1216927771832ccea0c79f\">caudate</span> atrophy.</p>\n<p><img alt=\"RA434\" data-author=\"\" data-hash=\"8284\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/7hPo6TM042dCzPAqHn1s1744187078.png\"/></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A <strong>rapidly progressive neurodegenerative disorder</strong> caused by prionsâmisfolded proteins that induce other proteins to misfold, leading to brain damage.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cognitive Decline:</strong> Rapid deterioration of mental function.</p>\n<p><strong>Behavioral Changes:</strong> Altered behavior and personality.</p>\n<p><strong>Myoclonus: </strong>Sudden muscle jerks.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diffusion-weighted <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> Findings:</strong> Increased signal intensity in the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> <span class=\"customMeta\" data-dictid=\"f2804c808516927771887dda93e56c\">ganglia</span> (particularly in the <span class=\"customMeta\" data-dictid=\"2aa1d2af521692777196435dcd12c5\">putamen</span> and <span class=\"customMeta\" data-dictid=\"1d14ed8c1216927771832ccea0c79f\">caudate</span> nuclei) and <strong>cortical ribboning.</strong></p>\n<p><img alt=\"RA435\" data-author=\"\" data-hash=\"8285\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uNMlOZ7Q5A570SYC9ojW1744187078.png\"/></p>\n<p><strong>Ventricular Enlargement:</strong> <span class=\"customMeta\" data-dictid=\"97ff5253fb169277718224c7b0faf8\">Atrophy</span> leading to enlarged ventricles</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Variant <span class=\"customMeta\" data-dictid=\"2fa320ed45169277718594fea874a8\">Creutzfeldt-Jakob Disease</span> (vCJD)</strong></p>\n<p>A subtype of <span class=\"customMeta\" data-dictid=\"d399073fe41692777184e21b19c221\">CJD</span> associated with consumption of beef products contaminated with BSE (bovine <span class=\"customMeta\" data-dictid=\"42a168437c16927771990017b153d4\">spongiform</span> encephalopathy).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Radiological Findings</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cortical Atrophy:</strong> Particularly in the <span class=\"customMeta\" data-dictid=\"77dc7a0ab81692777194dba7ab78ab\">occipital</span> and <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> lobes.</p>\n<p><strong>Increased Signal Intensity on MRI: </strong>Observed in affected areas, especially in the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> <span class=\"customMeta\" data-dictid=\"f2804c808516927771887dda93e56c\">ganglia</span> and cerebral cortex.</p>\n<p><strong>Pulvinar Sign (Image A):</strong> Increased signal intensity in the <span class=\"customMeta\" data-dictid=\"b36e8ba0101692777196f1b3621e90\">pulvinar</span> <span class=\"customMeta\" data-dictid=\"ff628904401692777193c8a9f9159e\">nucleus</span> of the thalamus.</p>\n<p><strong>Hockey Stick Sign (Image B): </strong>A characteristic appearance on MRI, indicating involvement of the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> thalamus.</p>\n<p><img alt=\"RA436\" data-author=\"\" data-hash=\"8286\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ZrfLSYMVFjSAluLLktq11744187079.png\"/></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A type of <strong>frontotemporal dementia</strong> characterized by <strong>early changes in personality, behavior, and social conduct.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Affected Areas</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily affects the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> and <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> lobes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Behavioral Abnormalities:</strong> Significant personality changes and social withdrawal.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Radiological Findings</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prominent <span class=\"customMeta\" data-dictid=\"666497f9c41692777199edd6cd1884\">Sulci</span> in the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">Frontal</span> Lobe:</strong> Indicates <span class=\"customMeta\" data-dictid=\"97ff5253fb169277718224c7b0faf8\">atrophy</span> of the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> lobe.</p>\n<p><strong>Symmetric Disproportionate <span class=\"customMeta\" data-dictid=\"97ff5253fb169277718224c7b0faf8\">Atrophy</span> of the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">Frontal</span> Lobe:</strong> A hallmark distinguishing it from other forms of dementia.</p>\n<p><img alt=\"RA437\" data-author=\"\" data-hash=\"8287\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/nOhzUnp0JFVCT3VJ24kk1744187079.png\"/></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>The most common <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of dementia,</strong> marked by progressive memory loss, cognitive decline, and changes in behavior and personality.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Accumulation of <span class=\"customMeta\" data-dictid=\"51ad856e041692777181f80c9d507a\">amyloid</span> plaques and <span class=\"customMeta\" data-dictid=\"5c9f1acf0016927771937147a035e1\">neurofibrillary tangles</span> in the brain.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Memory Impairment: </strong>Often the earliest symptom reported is difficulty remembering recent events.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Radiological Findings</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bilateral Symmetric Disproportionate <span class=\"customMeta\" data-dictid=\"97ff5253fb169277718224c7b0faf8\">Atrophy</span> of the Hippocampus:</strong> Affects memory function.</p>\n<p><strong>Prominent <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Horns of the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">Lateral</span> Ventricles:</strong> An <span class=\"customMeta\" data-dictid=\"2f73e160ba1692777190d65065c95b\">indirect</span> sign of hippocampal atrophy, indicating significant <span class=\"customMeta\" data-dictid=\"88a68ed2991692777193a28c3c0047\">neurodegeneration</span> in the <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> lobes.</p>\n<p><img alt=\"RA438\" data-author=\"\" data-hash=\"8288\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/un6NKQEoSddwyppXlY5Q1744187080.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 3-year-old child presents with progressive motor decline, cognitive regression, and spasticity. MRI shows confluent and symmetric hyperintense T2 signals in the periventricular and deep white matter, with sparing of subcortical U fibers &amp;amp; tigroid pattern is noted. What is the underlying enzymatic deficiency?", "options": [{"label": "A", "text": "Aspartoacylase deficiency", "correct": false}, {"label": "B", "text": "Arylsulfatase A deficiency", "correct": true}, {"label": "C", "text": "β-Galactocerebrosidase deficiency", "correct": false}, {"label": "D", "text": "Glutaryl-CoA deficiency", "correct": false}], "correct_answer": "B. Arylsulfatase A deficiency", "question_images": ["https://image.prepladder.com/notes/0oeFFke6kaZ2kYsIWbig1744188492.png"], "explanation_images": ["https://image.prepladder.com/notes/V5RNj6X6uGB0QwUQuXak1744188492.png", "https://image.prepladder.com/notes/4A5bOvfRyYZ6PjOv6R6e1744188494.png", "https://image.prepladder.com/notes/uNCdWvmhfkEv5V8Rzo611744188494.png", "https://image.prepladder.com/notes/fIpeDjMD6Hc85HsaMPDO1744188495.png", "https://image.prepladder.com/notes/x10g2ejbtE3Zp6dpeohv1744188496.png", "https://image.prepladder.com/notes/drry9yUSGJMS0nkoCh7N1744188496.png"], "explanation": "<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td colspan=\"1\" rowspan=\"2\"><img alt=\"RA449\" data-author=\"\" data-hash=\"8299\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/V5RNj6X6uGB0QwUQuXak1744188492.png\"/></td>\n<td style=\"text-align:center\"><strong>Metachromatic leukodystrophy</strong></td>\n</tr>\n<tr>\n<td>\n<ul>\n<li>Caused by a <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> of the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> <strong>Arylsulfatase A </strong><strong>(Option B)</strong></li>\n<li>Characterized by <span class=\"customMeta\" data-dictid=\"8793eea96e169277718446e2ea701a\">confluent</span> and symmetric<strong> <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> T2 </strong>signals in the<strong> periventricular</strong> and <strong>deep white matter</strong>, while <span class=\"customMeta\" data-dictid=\"c4960c2ad8169277719913d61ad2a9\">subcortical</span> U fibers are relatively spared.</li>\n<li>The<strong> perivenular <span class=\"customMeta\" data-dictid=\"47fec911a316927771933b7607bdf0\">myelin</span> </strong>shows <strong>relative sparing</strong>, creating a <strong>tigroid pattern.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"2\"><img alt=\"RA450\" data-author=\"\" data-hash=\"8300\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"508\" src=\"https://image.prepladder.com/notes/4A5bOvfRyYZ6PjOv6R6e1744188494.png\" width=\"400\"/></td>\n<td style=\"text-align:center\"><strong>Alexander disease</strong></td>\n</tr>\n<tr>\n<td>\n<ul>\n<li>Three clinical forms exist: infantile, juvenile, and adult, with the<strong> infantile</strong> <strong>form </strong>being the most common, presenting with <strong>macrocephaly</strong>.</li>\n<li>Characteristic<strong> T2 hyperintense</strong> signal in<strong> bifrontal white matter</strong>.</li>\n<li>Early disease may show intense post-contrast enhancement.</li>\n<li>Histopathologically characterized by <strong>Rosenthal fibers</strong> in the brain.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"2\"><img alt=\"RA451\" data-author=\"\" data-hash=\"8301\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uNCdWvmhfkEv5V8Rzo611744188494.png\"/></td>\n<td style=\"text-align:center\"><strong>Adrenoleukodystrophy </strong></td>\n</tr>\n<tr>\n<td>\n<ul>\n<li>An inherited <span class=\"customMeta\" data-dictid=\"dd35346fc716927772029e2f0bb10f\">X-linked</span> peroxisomal disorder caused by a <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> in the<strong> ABCD1 gene</strong>.</li>\n<li>Accumulation of very long-chain <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acids in the white matter.</li>\n<li>Confluent <strong>T2 <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> signal</strong> in <span class=\"customMeta\" data-dictid=\"a71c8cfa8216927771955861218d80\">periventricular</span> and deep white matter, especially in <strong>peritrigonal regions</strong>.</li>\n<li>Marked<strong> rim enhancement</strong> on <strong>post-contrast T1</strong> images at the leading edge indicates <strong>perivascular inflammation</strong> <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to demyelination.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"2\"><img alt=\"RA452\" data-author=\"\" data-hash=\"8302\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/fIpeDjMD6Hc85HsaMPDO1744188495.png\"/></td>\n<td>\n<p style=\"text-align:center\"><strong>Glutaric <span class=\"customMeta\" data-dictid=\"797c60cbe916927771805dc5900148\">aciduria</span> <span class=\"customMeta\" data-dictid=\"946a9a6be11692777201eb269e8327\">type I</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<ul>\n<li>It is caused by an inherited <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> of the enzyme<strong> glutaryl-CoA. </strong><strong>(Option D)</strong></li>\n<li>Atrophy or <span class=\"customMeta\" data-dictid=\"35c595890e1692777189a68438427a\">hypoplasia</span> of the <strong>frontotemporal regions</strong>.</li>\n<li>Enlarged <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> spaces.</li>\n<li>Cyst-like <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">dilation</span> of the <span class=\"customMeta\" data-dictid=\"c76557c9e1169277719955ac4ecac7\">Sylvian</span> fissures with a <strong>\"batwing\"</strong> appearance.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"text-align:center\"><strong>Globoid <span class=\"customMeta\" data-dictid=\"b633cfa7eb1692777191c07f66b54c\">Leukodystrophy</span> (Krabbeâs Disease)</strong></td>\n</tr>\n<tr>\n<td colspan=\"2\">\n<p><img alt=\"RA453\" data-author=\"\" data-hash=\"8303\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/x10g2ejbtE3Zp6dpeohv1744188496.png\"/></p>\n<ul>\n<li>A lysosomal disorder caused by a <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> of the enzyme<strong> β-galactocerebrosidase</strong>. <strong>(Option C)</strong></li>\n<li><strong>CT</strong> shows<strong> <span class=\"customMeta\" data-dictid=\"d963da62eb16927771993737a99c7c\">symmetrical</span> hyperdensity</strong> in the<strong> <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia</strong>, <strong>thalami</strong>, <strong>cerebellum</strong>, and <span class=\"customMeta\" data-dictid=\"f2f39af5b7169277718598133664e4\">corona</span> radiata.</li>\n<li>Enlargement of the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"80958d59861692777184c032f141a2\">chiasm</span> and <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerves</li>\n<li>MRI reveals confluent, <strong>symmetric T2 <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> </strong>signals in the <strong>periventricular</strong> and deep white matter.</li>\n<li>Alternating <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> and <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> signals in the cerebellar <span class=\"customMeta\" data-dictid=\"faffdfe705169277720242bf7ee9b5\">white matter</span> surrounding the <span class=\"customMeta\" data-dictid=\"e0c09f9e461692777185212f4de159\">dentate</span> nuclei.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"text-align:center\"><strong>Canavan Disease</strong></td>\n</tr>\n<tr>\n<td colspan=\"2\">\n<p><img alt=\"RA454\" data-author=\"\" data-hash=\"8304\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"462\" src=\"https://image.prepladder.com/notes/drry9yUSGJMS0nkoCh7N1744188496.png\" width=\"400\"/></p>\n<ul>\n<li>An autosomal <span class=\"customMeta\" data-dictid=\"d54db2110416927771971e7c011a9f\">recessive</span> disorder caused by a <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> of the <strong>aspartoacylase enzyme</strong>. <strong>(Option A)</strong></li>\n<li>Leads to <strong>increased</strong> levels of <strong>N-acetyl <span class=\"customMeta\" data-dictid=\"3d988dbcc816927771821e9a2544f7\">aspartate</span> (NAA)</strong> in the brain, resulting in <strong>spongiform <span class=\"customMeta\" data-dictid=\"df4f1758e2169277718697ae66f3dd\">degeneration</span> </strong>of<strong> white matter</strong>, <span class=\"customMeta\" data-dictid=\"86c230abe316927771889bbef8df5d\">globus</span> pallidus, and thalami.</li>\n<li>Presents with <span class=\"customMeta\" data-dictid=\"be4655aa771692777191f2dbef3d4a\">macrocephaly</span> and hypotonia</li>\n<li>On <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> there is<strong> </strong>Involvement of <span class=\"customMeta\" data-dictid=\"c4960c2ad8169277719913d61ad2a9\">subcortical</span> U fibers, thalamus, and <span class=\"customMeta\" data-dictid=\"86c230abe316927771889bbef8df5d\">globus</span> pallidus, with relative sparing of the internal capsules and putamen.</li>\n<li>The distinctive finding on <strong>MR <span class=\"customMeta\" data-dictid=\"b858e183101692777198186309ea61\">spectroscopy</span> </strong>is an increase in <strong>N-acetylaspartate (NAA)</strong>.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:592px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Peak and Metabolite</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Normal Function</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lipid (1.3 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Marker of tissue necrosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tuberculosis, Glioblastoma, Cerebral infarction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>N-Acetylaspartate (NAA, 2.0 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Marker of neuronal health and density</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Canavan Disease, Alzheimerâs, Gliomas</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Choline (Cho, 3.2 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reflects cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> turnover</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tumors, Demyelinating diseases, <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">Hepatic</span> encephalopathy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Creatine (Cr, ~3.0 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Energy <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> marker</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Variable (often stable marker)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lactate (1.3 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anaerobic <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> marker</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypoxia, Stroke, Mitochondrial Disorders</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Myo-inositol (~3.5 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Osmoregulation and glial cell marker</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alzheimerâs, Meningiomas, <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">Hepatic</span> encephalopathy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acetate &amp; <span class=\"customMeta\" data-dictid=\"cf0e807d031692777199f6fd7c6afd\">Succinate</span> (~2.0 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intermediate metabolites in <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> processes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bacterial abscesses, <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">Metabolic</span> disorders</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Taurine (~3.4 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Osmoregulation, <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> salt conjugation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pediatric brain tumors (e.g., medulloblastoma)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 75-year-old female presents to the clinic with a 6-month history of progressive difficulty in walking, frequent urinary urgency, and occasional episodes of confusion. Imaging is performed, revealing ventriculomegaly and effacement of the sulci at the vertex as shown. Which of the following statements about the condition is false?", "options": [{"label": "A", "text": "It is idiopathic but can be caused due to past injuries", "correct": false}, {"label": "B", "text": "The Evans ratio is less than 0.31", "correct": true}, {"label": "C", "text": "The callosal angle is less than 90 degrees", "correct": false}, {"label": "D", "text": "A disproportionately enlarged subarachnoid space is seen", "correct": false}], "correct_answer": "B. The Evans ratio is less than 0.31", "question_images": ["https://image.prepladder.com/notes/yXEDLPlbOrcwgyWsm6lE1744196226.png"], "explanation_images": ["https://image.prepladder.com/notes/Hy9gk2NQVCAktgt1kpPI1744196226.png", "https://image.prepladder.com/notes/wQSOlMojJs4FE3HQpd7A1744196225.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:710px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Normal Pressure <span class=\"customMeta\" data-dictid=\"018823377416927771896f6aa736a4\">Hydrocephalus</span> (NPH)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NPH is often <span class=\"customMeta\" data-dictid=\"4acddc3cf5169277718996440e2e14\">idiopathic</span> but can result from prior injuries affecting <span class=\"customMeta\" data-dictid=\"99a9bf133e1692777184ec4b1011fe\">cerebrospinal</span> fluid (CSF) dynamics, such as <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> hemorrhage. <strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gait disturbance: progressive difficulties in walking</li>\n<li>Urinary issues: <span class=\"customMeta\" data-dictid=\"026c92ea6316927772013c7cfd287b\">urgency</span> or incontinence</li>\n<li>Cognitive impairment: decline in cognitive functions</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ventriculomegaly is typically seen</li>\n<li><strong>Evans ratio</strong>: the ratio of the maximum <span class=\"customMeta\" data-dictid=\"1b0d31fe811692777202644090ba60\">width</span> of <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> horns to inner table <span class=\"customMeta\" data-dictid=\"1b0d31fe811692777202644090ba60\">width</span> of <strong>more than 0.31 </strong>is often used for evaluation but has low <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> accuracy.</li>\n<li>An <strong>acute <span class=\"customMeta\" data-dictid=\"3d75814381169277718350f5548cc1\">callosal</span> angle </strong>(less than 90°) on <span class=\"customMeta\" data-dictid=\"dad5b2152216927771851a3d10cd41\">coronal</span> MR images is another measurement used, also with limited accuracy. <strong>(Option C)</strong></li>\n<li>A<strong> disproportionately enlarged <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space <span class=\"customMeta\" data-dictid=\"018823377416927771896f6aa736a4\">hydrocephalus</span> </strong><strong>(Option D)</strong> is seen having <span class=\"customMeta\" data-dictid=\"8501c4040a1692777201eb9e7ea8f6\">ventriculomegaly</span> combined with sulcal <span class=\"customMeta\" data-dictid=\"dc0035cd191692777187b9b8b2af69\">effacement</span> at the <span class=\"customMeta\" data-dictid=\"47effe8b551692777201331142edf5\">vertex</span> and scattered enlarged sulci.</li>\n<li>CSF flow study shows hyper-dynamism with a streak of flow <span class=\"customMeta\" data-dictid=\"3ea4fc34801692777202b98af71861\">void</span> through cerebral aqueduct.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 6-year-old boy presents to the pediatric neurologist with a history of recurrent seizures since he was 1 year old. Upon examination, a port wine stain is noted on the right side of his face. What imaging findings would you expect to see in this patient, considering SturgeâWeber Syndrome?", "options": [{"label": "A", "text": "Normal MRI with no abnormality", "correct": false}, {"label": "B", "text": "Cystic lesions with enhancing mural nodules in the cerebellum", "correct": false}, {"label": "C", "text": "Tramline calcifications and atrophy of the affected hemisphere", "correct": true}, {"label": "D", "text": "Cerebellar atrophy", "correct": false}], "correct_answer": "C. Tramline calcifications and atrophy of the affected hemisphere", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/RKIAFHvyCgo6kdjFAmYP1744195843.png", "https://image.prepladder.com/notes/PpMz4j9KgegaRLSJrEQM1744195844.png", "https://image.prepladder.com/notes/Ntn5j6bY7ZAxwF0goGiC1744195845.png", "https://image.prepladder.com/notes/teGyApxZjkj9LnSyaf5Z1744196104.png", "https://image.prepladder.com/notes/76MXL6IJLydzC2Pr1NJx1744195845.png", "https://image.prepladder.com/notes/S0gIkUX1DQGAUTmzzkqx1744196100.png", "https://image.prepladder.com/notes/txs1w8Fvf6a3qA76gjLd1744196100.png", "https://image.prepladder.com/notes/7LeziejVKbDA3gShQOWC1744196102.png", "https://image.prepladder.com/notes/dfBlcAJjDkJwRP6oayER1744196103.png", "https://image.prepladder.com/notes/j2F3meUAB5p5HKo9bMUh1744196103.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An infant undergoes a brain MRI that reveals a crescent-shaped mass filling the entire ventricular system, with the interhemispheric fissure not visible. The cerebrum exhibits a pancake-like appearance of the cerebral tissue, and there are no identifiable structures of the corpus callosum or falx cerebri. Which of the following conditions is the most likely diagnosis for this infant?", "options": [{"label": "A", "text": "Alobar holoprosencephaly", "correct": true}, {"label": "B", "text": "Schizencephaly", "correct": false}, {"label": "C", "text": "Lissencephaly", "correct": false}, {"label": "D", "text": "Lobar holoprosencephaly", "correct": false}], "correct_answer": "A. Alobar holoprosencephaly", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/eTqdrAcCMul8nyQOHkKJ1744195515.png", "https://image.prepladder.com/notes/YHwsP8YIJNU46sNiIrOu1744195514.png", "https://image.prepladder.com/notes/lND4inLCxrIEwstbwAm51744195514.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:312px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Holoprosencephaly</strong></p>\n<ul>\n<li>Holoprosencephaly is a <span class=\"customMeta\" data-dictid=\"a3b45f45fc1692777203eceaf9f4d3\">forebrain</span> <span class=\"customMeta\" data-dictid=\"88900fc4c61692777191a66457050a\">malformation</span> caused by incomplete separation of the cerebral hemispheres, associated with <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> deformities.</li>\n<li>It has varying severity, classified into\n\t\t\t\t<ul>\n<li>Alobar</li>\n<li>Semilobar</li>\n<li>Lobar</li>\n<li>Interhemispheric types</li>\n</ul>\n</li>\n</ul>\n<p>Imaging Findings:</p>\n<ul>\n<li><strong>Alobar</strong>:\n\n\t\t\t\t<ul>\n<li><strong>Crescent-shaped holo ventricle</strong> with no <span class=\"customMeta\" data-dictid=\"54ef35522a169277719061708f63a2\">interhemispheric</span> fissure</li>\n<li>Cerebrum has a <strong>pancake</strong>-<strong>like</strong> mass of tissue on imaging</li>\n<li>No <span class=\"customMeta\" data-dictid=\"54ef35522a169277719061708f63a2\">interhemispheric</span> fissure, <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> callosum, or <span class=\"customMeta\" data-dictid=\"3f271f790f1692777202ab3200a8f3\">falx</span> cerebri</li>\n</ul>\n</li>\n<li>Semilobar:\n\t\t\t\t<ul>\n<li>Partial separation of the hemispheres, presenting with a <strong>single ventricle</strong></li>\n<li>Mild <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> abnormalities</li>\n</ul>\n</li>\n<li><strong>Lobar </strong><strong>(Option D)</strong>:\n\t\t\t\t<ul>\n<li>Near-normal separation of hemispheres with some continuous <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> between the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> lobes</li>\n<li>Typically shows normal brain volume</li>\n</ul>\n</li>\n<li>Interhemispheric (Syntelencephaly):\n\t\t\t\t<ul>\n<li>Anterior and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> fissures are present, but the middle lacks an <span class=\"customMeta\" data-dictid=\"54ef35522a169277719061708f63a2\">interhemispheric</span> <span class=\"customMeta\" data-dictid=\"b2af124a931692777203c9f8031b77\">fissure</span> with fused <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> and <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> lobes</li>\n</ul>\n</li>\n</ul>\n<img alt=\"RA497\" data-author=\"\" data-hash=\"8355\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/eTqdrAcCMul8nyQOHkKJ1744195515.png\"/><br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Schizencephaly </strong><strong>(Option B): </strong></p>\n<ul>\n<li>Schizencephaly is a <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> in the cerebral <span class=\"customMeta\" data-dictid=\"5ec65d4890169277719136decb922c\">mantle</span> characterized by a <span class=\"customMeta\" data-dictid=\"7aa38569251692777184021705e8de\">cleft</span> that connects the <span class=\"customMeta\" data-dictid=\"373c8804a716927771836d8c7fa5cd\">calvarium</span> with the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> ventricles, lined with grey matter and leptomeninges.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"7aa38569251692777184021705e8de\">cleft</span> can be classified as:\n\t\t\t\t<ul>\n<li>Open lip (wide-open defect)</li>\n<li>Closed lip (closed but lined with grey matter)</li>\n</ul>\n</li>\n</ul>\n<p>Imaging Findings:</p>\n<ul>\n<li>CT: <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> ventricles may show clefts and abnormalities in the <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> mantle.</li>\n<li>MRI:\n\t\t\t\t<ul>\n<li>Closed lip forms are best visualized showing <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> due to polymicrogyria</li>\n<li>Potential <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> developmental abnormalities are visualized as well</li>\n</ul>\n</li>\n</ul>\n<p><img alt=\"RA496\" data-author=\"\" data-hash=\"8354\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/YHwsP8YIJNU46sNiIrOu1744195514.png\"/></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lissencephaly </strong><strong>(Option C):</strong></p>\n<ul>\n<li><strong>Lissencephaly, or \"smooth brain,\"</strong> involves <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> neuronal migration resulting in a thickened <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> with few or no gyri, often associated with <span class=\"customMeta\" data-dictid=\"133b86a0a516927771809ea08682e8\">agenesis</span> of the <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> callosum.</li>\n<li>It can be categorized into complete <span class=\"customMeta\" data-dictid=\"0e897b5a5b1692777191f38e94f1e1\">lissencephaly</span> (no gyri) and incomplete <span class=\"customMeta\" data-dictid=\"0e897b5a5b1692777191f38e94f1e1\">lissencephaly</span> (fewer, broader gyri).</li>\n</ul>\n<p>Imaging Findings:</p>\n<ul>\n<li>MRI:\n\t\t\t\t<ul>\n<li>Shows a smooth <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> surface</li>\n<li>Shallow and wide <span class=\"customMeta\" data-dictid=\"c76557c9e1169277719955ac4ecac7\">Sylvian</span> fissures</li>\n<li>A thin outer <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> layer with a thicker band of grey matter underneath</li>\n</ul>\n</li>\n</ul>\n<p><img alt=\"RA495\" data-author=\"\" data-hash=\"8353\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/lND4inLCxrIEwstbwAm51744195514.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The brain imaging of a child reveals the following: What is the classical appearance of the lateral ventricles in this image called?", "options": [{"label": "A", "text": "Batwing appearance", "correct": false}, {"label": "B", "text": "Sunray appearance", "correct": false}, {"label": "C", "text": "Race car appearance", "correct": true}, {"label": "D", "text": "Moose-head appearance", "correct": false}], "correct_answer": "C. Race car appearance", "question_images": ["https://image.prepladder.com/notes/TQOF2JDx5ehyVU2nUM2E1744195227.png"], "explanation_images": ["https://image.prepladder.com/notes/CqYaIjbrleBkTpA1yJ6O1744195229.png", "https://image.prepladder.com/notes/a2wQrfkw1EVaLRGqfVzO1744195228.png", "https://image.prepladder.com/notes/fiRiezFehAZIHKh3Pk9R1744195230.png", "https://image.prepladder.com/notes/rRTnWOfF0X0XehDMZGRE1744195231.png", "https://image.prepladder.com/notes/Wkif4s7bkpxNTcYswJhs1744195231.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 3-month-old infant is evaluated for developmental delays and abnormal head shape. An MRI reveals a dysplastic cerebellum with an everted inferior vermis. Which type of Chiari malformation is most likely indicated by these findings?", "options": [{"label": "A", "text": "Chiari Type I", "correct": false}, {"label": "B", "text": "Chiari Type II", "correct": true}, {"label": "C", "text": "Chiari Type III", "correct": false}, {"label": "D", "text": "Chiari Type IV", "correct": false}], "correct_answer": "B. Chiari Type II", "question_images": ["https://image.prepladder.com/notes/1xHQ9vXObXaxf8jdjiqP1744194939.png"], "explanation_images": ["https://image.prepladder.com/notes/wCWAgeqd7EjTkOT67sJw1744194940.png", "https://image.prepladder.com/notes/KmHHvJqaE21tPb4gjb521744194940.png", "https://image.prepladder.com/notes/jEaS8Tngh4TpdJTlOrVK1744194941.png", "https://image.prepladder.com/notes/0FCMarVTjvwDO5vJuwfn1744194417.png", "https://image.prepladder.com/notes/AeAAWIOMBTPPEIj9qWcN1744194416.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:100%\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chiari <span class=\"customMeta\" data-dictid=\"946a9a6be11692777201eb269e8327\">Type I</span> <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> or cerebellar <span class=\"customMeta\" data-dictid=\"90d1792ffd1692777186055806b5ce\">ectopia</span> </strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chiari <span class=\"customMeta\" data-dictid=\"bd04ba63bc1692777201f54e0ee060\">Type II</span> </strong><strong>malformations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chiari Type III</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Involves the <span class=\"customMeta\" data-dictid=\"e9449b4d7a16927771867eb16e2878\">descent</span> of normal cerebellar hemispheres below the <span class=\"customMeta\" data-dictid=\"9f027343dd16927772039cf6b0c8e4\">foramen</span> magnum, often with pointed tonsils.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Defined by a dysplastic</p>\n<p>cerebellum with an</p>\n<p>everted <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> vermis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>This is a rare type.</li>\n<li>Involves <span class=\"customMeta\" data-dictid=\"7133d43878169277718890fcb091d5\">herniation</span> of the <span class=\"customMeta\" data-dictid=\"66d77a7e4316927771897090175497\">hindbrain</span> (cerebellum with or without brainstem).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anatomical changes </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"13c335973d1692777184ceae2d4f6f\">cisterna</span> magna is often obliterated.</li>\n<li>Medulla <span class=\"customMeta\" data-dictid=\"f0a86647fe1692777194962e864d8f\">oblongata</span> <span class=\"customMeta\" data-dictid=\"3e53f6980f1692777187044dd3f9e7\">elongation</span> occurs leading to kinking as the fourth <span class=\"customMeta\" data-dictid=\"707de303e516927772011cb80f4028\">ventricle</span> tail rolls over the <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> cord as it descends into the <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">cervical</span> canal.</li>\n<li>Occipitalisation of the <span class=\"customMeta\" data-dictid=\"305201d7261692777182bd15a8d297\">atlas</span> and <span class=\"customMeta\" data-dictid=\"cf3585c06f1692777182cba3cb4c97\">basilar</span> <span class=\"customMeta\" data-dictid=\"4ae704fdbb1692777190fb609e2290\">invagination</span> is seen.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"a9c41a58d816927771847775d63d96\">cerebellum</span> herniates mainly involving the <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> vermis.</li>\n<li>Medulla <span class=\"customMeta\" data-dictid=\"f0a86647fe1692777194962e864d8f\">oblongata</span> is elongated and may become kinked.</li>\n<li>Compression and progressive <span class=\"customMeta\" data-dictid=\"df4f1758e2169277718697ae66f3dd\">degeneration</span> of the brainstem, cerebellum, and upper <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> cord.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Brain anomalies of Type II</li>\n<li>Occipital or <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">cervical</span> encephalocele</li>\n<li>Occipital bone defect</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Associated presentations </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Patients become <span class=\"customMeta\" data-dictid=\"509310d4411692777199f2ffdb7769\">symptomatic</span> only in adulthood and it is often associated with syringomyelia.</li>\n<li>Ectopia of â¤2 mm is usually considered normal, while âĽ5 mm is considered abnormal.</li>\n<li>MRI findings tend to overestimate the prevalence.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hydrocephalus</li>\n<li>Dysplasia of the cerebral hemisphere, <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> vaults, and meninges.</li>\n<li>Meningomyelocele is present in 98% of cases.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A low <span class=\"customMeta\" data-dictid=\"77dc7a0ab81692777194dba7ab78ab\">occipital</span> or high <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">cervical</span> meningoencephalocele.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI images in the <span class=\"customMeta\" data-dictid=\"dad5b2152216927771851a3d10cd41\">coronal</span> plane</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<img alt=\"RA1044\" data-author=\"\" data-hash=\"8344\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"312\" src=\"https://image.prepladder.com/notes/wCWAgeqd7EjTkOT67sJw1744194940.png\" width=\"300\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA1050\" data-author=\"\" data-hash=\"8345\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"395\" src=\"https://image.prepladder.com/notes/KmHHvJqaE21tPb4gjb521744194940.png\" width=\"300\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA1051\" data-author=\"\" data-hash=\"8346\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"290\" src=\"https://image.prepladder.com/notes/jEaS8Tngh4TpdJTlOrVK1744194941.png\" width=\"300\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fetal <span class=\"customMeta\" data-dictid=\"2f728bd574169277719835f6456848\">sonography</span> findings</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Lemon sign:</strong> <span class=\"customMeta\" data-dictid=\"13d0edf82916927772021bfc7f9aeb\">flattening</span> or inward scalloping or bowing of the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> bone.</li>\n<li><strong>Banana sign: </strong>due to <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> of the <span class=\"customMeta\" data-dictid=\"a9c41a58d816927771847775d63d96\">cerebellum</span> or <span class=\"customMeta\" data-dictid=\"e5922b669a169277719487f8bbabd3\">obliteration</span> of <span class=\"customMeta\" data-dictid=\"13c335973d1692777184ceae2d4f6f\">cisterna</span> magna.</li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"RA488\" data-author=\"\" data-hash=\"8338\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"285\" src=\"https://image.prepladder.com/notes/0FCMarVTjvwDO5vJuwfn1744194417.png\" width=\"300\"/></p>\n<p style=\"text-align:center\"><img alt=\"RA487\" data-author=\"\" data-hash=\"8337\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"251\" src=\"https://image.prepladder.com/notes/AeAAWIOMBTPPEIj9qWcN1744194416.png\" width=\"300\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 10-year-old boy presents with progressive headaches, vision changes, and growth delay. Neurological examination reveals bitemporal hemianopia. MRI of the brain shows a large, lobulated, multiloculated cystic lesion with a small enhancing solid component and calcifications in the suprasellar region. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pituitary adenoma", "correct": false}, {"label": "B", "text": "Craniopharyngioma", "correct": true}, {"label": "C", "text": "Melanoma", "correct": false}, {"label": "D", "text": "Astrocytoma", "correct": false}], "correct_answer": "B. Craniopharyngioma", "question_images": ["https://image.prepladder.com/notes/VTXmyG6QEZPM8r175MD21744194415.png"], "explanation_images": ["https://image.prepladder.com/notes/JzL4SNuNHc10y9iD3Kko1744194758.png", "https://image.prepladder.com/notes/64or5umFZ90iMtJRutYP1744194621.png", "https://image.prepladder.com/notes/18m0rQJTtHaJbPnSROia1744194621.png", "https://image.prepladder.com/notes/SZ4FwgJ22VMURhDfe7zi1744194622.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<h3 style=\"text-align:center\"><strong>Craniopharyngioma </strong><strong>(Option B)</strong></h3>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA1042\" data-author=\"\" data-hash=\"8342\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/JzL4SNuNHc10y9iD3Kko1744194758.png\"/>\n<ul>\n<li>Craniopharyngiomas are <strong>suprasellar tumors</strong> that develop from remnants of the <span class=\"customMeta\" data-dictid=\"033ae9cbaf16927771858933478ef9\">craniopharyngeal</span> <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> or <strong>Rathkeâs pouch</strong>.</li>\n<li>It <span class=\"customMeta\" data-dictid=\"c6486470671692777184e25019e1f0\">compress</span> <strong>Optic chaism </strong>leads to <strong>bitemporal hemianopia.</strong></li>\n<li><strong>Adamantinomatous subtype</strong></li>\n</ul>\n<ul>\n<li>It<strong> </strong>is more common</li>\n<li>Seen in<strong> children</strong></li>\n<li>Typically appear as <strong>large, lobulated, multiloculated <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> lesions</strong> with a small enhancing solid component and<strong> calcifications</strong>.</li>\n</ul>\n<ul>\n<li><strong>Papillary subtype </strong></li>\n</ul>\n<ul>\n<li>Seen in Adults</li>\n<li>Primarily solid lesion</li>\n<li>Rarely exhibit calcifications</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<h3 style=\"text-align:center\"><strong>Pituitary <span class=\"customMeta\" data-dictid=\"c3c9726266169277718021f4f0fa16\">Adenoma</span> </strong><strong>(Option A)</strong></h3>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA1018\" data-author=\"\" data-hash=\"8339\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/64or5umFZ90iMtJRutYP1744194621.png\"/><img alt=\"RA1019\" data-author=\"\" data-hash=\"8340\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/18m0rQJTtHaJbPnSROia1744194621.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pituitary Microadenomas </strong></p>\n<ul>\n<li><strong>Less than 10 mm</strong> in size.</li>\n<li>Microadenomas appear <span class=\"customMeta\" data-dictid=\"ad45f1e11716927771901f3d9b18eb\">isointense</span> to the <span class=\"customMeta\" data-dictid=\"b775f0c475169277719593c573f6ff\">pituitary</span> on T1-weighted images and slightly <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> on T2-weighted images.</li>\n<li>In <strong>dynamic contrast-enhanced MRI</strong>, they <strong>enhance slowly compared</strong> to the surrounding <span class=\"customMeta\" data-dictid=\"b775f0c475169277719593c573f6ff\">pituitary</span> gland.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pituitary Macroadenomas</strong></p>\n<ul>\n<li><strong>Larger than 10 mm</strong> in size.</li>\n<li>Most of the macroadenomas are<strong> nonfunctioning.</strong></li>\n<li>They may cause <span class=\"customMeta\" data-dictid=\"d8216cf7571692777187baa94b8612\">endocrine</span> disturbances or <span class=\"customMeta\" data-dictid=\"c6486470671692777184e25019e1f0\">compress</span> the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> chiasm, leading to <span class=\"customMeta\" data-dictid=\"3b17da47ce16927771831d5dde3af3\">bitemporal</span> hemianopia.</li>\n<li>Typically appear as <strong>sellar-suprasellar masses</strong> with a <strong>âsnowmanâ </strong>or <strong>âfigure of eightâ </strong>appearance due to a <strong>waist at the <span class=\"customMeta\" data-dictid=\"1c1845d29e16927771860d473fc57c\">diaphragma</span> sellae</strong>.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"02db2e09e91692777198e14771cb3b\">sella</span> is usually enlarged.</li>\n<li>These tumors can invade the <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">cavernous</span> sinuses.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<h3><strong>Melanoma </strong><strong>(Option C)</strong></h3>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA1020\" data-author=\"\" data-hash=\"8341\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/SZ4FwgJ22VMURhDfe7zi1744194622.png\"/>\n<ul>\n<li><strong>T1 Imaging</strong>: Typically <strong>hyperintense</strong> due to <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> or<strong> melanin</strong>.</li>\n<li><strong>T2 Imaging</strong>: Typically<strong> hypointense</strong>.</li>\n<li>T1 C+ Imaging: Shows <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> usually in a <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> rim pattern or a diffusely <span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">heterogeneous</span> pattern.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 6-year-old boy presents with headache, nausea, and balance difficulties. MRI reveals a hyperdense mass in the midline cerebellar vermis, with surrounding vasogenic edema and hydrocephalus. The mass shows restricted diffusion on MRI and homogeneous contrast enhancement. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Ependymoma", "correct": false}, {"label": "B", "text": "Medulloblastoma", "correct": true}, {"label": "C", "text": "Cerebellar Pilocytic Astrocytoma", "correct": false}, {"label": "D", "text": "CNS Lymphoma", "correct": false}], "correct_answer": "B. Medulloblastoma", "question_images": ["https://image.prepladder.com/notes/Wgd70ZZZ1sZTZjv0e8AZ1744193545.png"], "explanation_images": ["https://image.prepladder.com/notes/TCMgnNrhryTUKUlxFaab1744193545.png", "https://image.prepladder.com/notes/ZQ2lbjIeYRYgJxsSp5o81744193545.png", "https://image.prepladder.com/notes/ZqlsMoR4GtxAiY5G7Plt1744193546.png", "https://image.prepladder.com/notes/QY8B3UdkpEfp5ARSYJWE1744193546.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<h3 style=\"text-align:center\"><strong>Ependymoma </strong><strong>(Option A)</strong></h3>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"RA482\" data-author=\"\" data-hash=\"8332\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/TCMgnNrhryTUKUlxFaab1744193545.png\"/></p>\n<ul>\n<li><strong>Ependymomas</strong> are glial tumors originating from the ependymal cells lining the brain's ventricles</li>\n<li><strong>Infratentorial (posterior fossa)</strong> tumors cause increased <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> pressure and hydrocephalus.<strong>Supratentorial tumors</strong> cause <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> neurological deficits, headaches, and seizures.</li>\n<li>Associated with <strong>neurofibromatosis 2</strong></li>\n<li><strong>Posterior <span class=\"customMeta\" data-dictid=\"30a1ba21881692777203de4e7b8537\">fossa</span> ependymomas</strong>: Appear as <span class=\"customMeta\" data-dictid=\"390a9178d716927771907c0c9d72c5\">intraventricular</span> masses <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> the <strong>4th ventricle</strong>, often extending through the <span class=\"customMeta\" data-dictid=\"f9856b87c216927772038555ec4258\">foramina</span> of Luschka and Magendie, resembling a<strong> \"plaster cast.\"</strong></li>\n<li><strong>Supratentorial ependymomas</strong>: Half are intraparenchymal.</li>\n<li>Ependymomas show<strong> heterogeneity</strong> with areas of necrosis, calcification, <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> changes, and hemorrhage.</li>\n<li>On MRI, they are <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> on T1, <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> on T2, with <span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">heterogeneous</span> <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> and possible restricted diffusion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Medulloblastoma </strong><strong>(Option B)</strong></td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA483\" data-author=\"\" data-hash=\"8333\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"396\" src=\"https://image.prepladder.com/notes/ZQ2lbjIeYRYgJxsSp5o81744193545.png\" width=\"700\"/></p>\n<ul>\n<li>Medulloblastomas are the <strong>most common <span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\">malignant</span> brain tumors</strong> in<strong> children</strong>.</li>\n<li>It is typically present as well-defined, <strong>hyperdense</strong> masses in the midline cerebellar vermis, often with surrounding <span class=\"customMeta\" data-dictid=\"c8013ecf46169277720128cab0a7b4\">vasogenic</span> edema, hydrocephalus, and <strong>homogeneous contrast enhancement</strong>.</li>\n<li>These tumors are T1 hypointense, T2 hyperintense, and heterogeneously enhancing, with surrounding edema, mass effect, and <strong>restricted diffusion</strong>.</li>\n<li>Typically arise in the <strong>midline cerebellar vermis</strong>.</li>\n<li>These tumors often bulge from the<strong> roof of the fourth ventricle</strong>, leading to<strong> obstructive hydrocephalus</strong> in children.</li>\n<li><strong>CSF seeding</strong> is common at presentation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Cerebellar <span class=\"customMeta\" data-dictid=\"7caecc3d25169277719524b215dbba\">Pilocytic</span> <span class=\"customMeta\" data-dictid=\"2c78f6552b16927771821c76e28243\">Astrocytoma</span> </strong><strong>(Option C)</strong></td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA484\" data-author=\"\" data-hash=\"8334\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"419\" src=\"https://image.prepladder.com/notes/ZqlsMoR4GtxAiY5G7Plt1744193546.png\" width=\"700\"/></p>\n<ul>\n<li><strong>Pilocytic <span class=\"customMeta\" data-dictid=\"2c78f6552b16927771821c76e28243\">astrocytoma</span> (PA)</strong> is a <span class=\"customMeta\" data-dictid=\"5297b5833216927771910b7a85de53\">low-grade</span> <strong>(WHO <span class=\"customMeta\" data-dictid=\"d4ae50897e16927771884b5c46ba7d\">grade</span> 1)</strong> astrocytoma, and it is <strong>well-circumscribed</strong></li>\n<li>It is the <strong>most common primary brain tumor</strong> in<strong> children</strong></li>\n<li>strongly associated with <span class=\"customMeta\" data-dictid=\"6518acf261169277719312127935af\">neurofibromatosis</span> type I<strong> (NF1)</strong></li>\n<li><strong>Cystic lesions</strong> with an <strong>enhancing <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">mural</span> nodule</strong>.</li>\n<li>Cystic component typically shows fluid signal, with <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> of the <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> wall</li>\n<li>The solid <span class=\"customMeta\" data-dictid=\"b61dc1c68d1692777193f8a6b8809b\">mural</span> <span class=\"customMeta\" data-dictid=\"6e6233ba551692777193c62c40bd5f\">nodule</span> is <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> on T1, <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> on T2, and shows intense enhancement.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Primary <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> Lymphoma</strong> <strong>(Option D)</strong></td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA485\" data-author=\"\" data-hash=\"8335\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"484\" src=\"https://image.prepladder.com/notes/QY8B3UdkpEfp5ARSYJWE1744193546.png\" width=\"400\"/></p>\n<ul>\n<li>Primary <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> <span class=\"customMeta\" data-dictid=\"5a31d184f21692777191a2e457d646\">Lymphoma</span> is a rare type of <strong>non-Hodgkin lymphoma</strong> associated with EBV.</li>\n<li>Primarily found in the <strong>periventricular area </strong>(along the ependymal surface of the ventricle) and within <strong>deep <span class=\"customMeta\" data-dictid=\"4baa7caf471692777188e7f07ce90e\">gray matter</span> nuclei</strong>.</li>\n<li><strong>CT Scan</strong>: Displays <span class=\"customMeta\" data-dictid=\"9729ba172a1692777198c816c4ad9c\">solitary</span> or multiple hyperdense, enhancing lesions</li>\n<li><strong>MRI:</strong> Lesions are typically <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> on T1 and<strong> iso/hypointense to <span class=\"customMeta\" data-dictid=\"4baa7caf471692777188e7f07ce90e\">gray matter</span> on T2-weighted</strong> images; most lesions exhibit intense <strong>homogeneous enhancement.</strong></li>\n<li><strong>MR Spectroscopy</strong>: Characterized by <strong>low N-acetylaspartate (NAA)</strong>, <strong>elevated <span class=\"customMeta\" data-dictid=\"ad6984dc581692777184936c84dd97\">choline</span> peaks.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old woman presents with progressive SNHL and non-pulsatile tinnitus in the right ear. MRI reveals a solid, enhancing mass in the internal auditory canal extending into the cerebellopontine angle, creating an \"ice cream cone\" appearance. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Glioblastoma Multiforme", "correct": false}, {"label": "B", "text": "Oligodendroglioma", "correct": false}, {"label": "C", "text": "Vestibular Schwannoma", "correct": true}, {"label": "D", "text": "Meningioma", "correct": false}], "correct_answer": "C. Vestibular Schwannoma", "question_images": ["https://image.prepladder.com/notes/dfW3ZTHwVc3HCpE7sz0b1744190074.png"], "explanation_images": ["https://image.prepladder.com/notes/vPUOLBu4EffLN3rcHkuG1744190074.png", "https://image.prepladder.com/notes/GSRjpwbcEnZoprgIE74C1744190074.png", "https://image.prepladder.com/notes/bxHgsWDrwCE1Izsfanm91744190075.png", "https://image.prepladder.com/notes/udWaTvLXquyYloIRAqnK1744190076.png", "https://image.prepladder.com/notes/rWGUY34HdH4aVDTlVejD1744190076.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:70%\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<h3 style=\"text-align:center\"><strong>Vestibular <span class=\"customMeta\" data-dictid=\"491e5b2e851692777198ba329e42ce\">Schwannoma</span> </strong><strong>(Option C)</strong></h3>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA476\" data-author=\"\" data-hash=\"8326\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/vPUOLBu4EffLN3rcHkuG1744190074.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Schwannomas are <strong>benign tumors</strong> that originate from Schwann cells forming the nerve sheath.</li>\n<li>Commonly arise from superior &amp; <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"e8b3c606051692777201faf2a1a357\">vestibular</span> divisions of the 8th <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve</li>\n<li>Usually solitary,<strong> B/L <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> tumors</strong> are seen in <strong>neurofibromatosis type 2</strong> <strong>(NF2)</strong>.</li>\n<li>presents with <strong>sensorineural hearing loss</strong> &amp; <strong>nonpulsatile tinnitus</strong>.</li>\n<li>On contrast-enhanced scans, it appears as solid,<strong> <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> enhancing masses </strong>in the internal <span class=\"customMeta\" data-dictid=\"f17057f75016927771829e70074368\">auditory</span> <span class=\"customMeta\" data-dictid=\"371930068716927771839cba840631\">canal</span> extending into the <strong>cerebellopontine angle cistern</strong>.</li>\n<li>Extracanalicular extension can produce an <strong>\"ice cream cone\"</strong> appearance.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Meningioma </strong><strong>(Option D)</strong></td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA477\" data-author=\"\" data-hash=\"8327\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"404\" src=\"https://image.prepladder.com/notes/GSRjpwbcEnZoprgIE74C1744190074.png\" width=\"400\"/></p>\n<p style=\"text-align:center\"><img alt=\"RA478\" data-author=\"\" data-hash=\"8328\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"440\" src=\"https://image.prepladder.com/notes/bxHgsWDrwCE1Izsfanm91744190075.png\" width=\"400\"/></p>\n<ul>\n<li>Meningiomas arise from <strong>arachnoidal cap cells</strong> in the brain and <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> cord coverings.</li>\n<li>They are the <strong>most common <span class=\"customMeta\" data-dictid=\"1bbae82f1f16927771824f797639fa\">benign</span> <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> tumors</strong>.</li>\n<li>Most common in females</li>\n<li>Mostly <span class=\"customMeta\" data-dictid=\"a325d0c14e16927771992fe8a96758\">sporadic</span> but can be <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to NF-2 or prior <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> irradiation.</li>\n<li>Meningiomas are <span class=\"customMeta\" data-dictid=\"bec08dbe0c16927771864d7774d7b0\">dural</span> based<strong> extra-axial </strong>masses that appear <span class=\"customMeta\" data-dictid=\"ad45f1e11716927771901f3d9b18eb\">isointense</span> to <span class=\"customMeta\" data-dictid=\"4baa7caf471692777188e7f07ce90e\">gray matter</span> on both T1 and T2-weighted images.</li>\n<li>They demonstrate intense<strong> <span class=\"customMeta\" data-dictid=\"d9ec45007b1692777189e3b26e44ca\">homogeneous</span> <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> </strong>on post-contrast imaging, accompanied by a <strong>dural tail sign</strong>.</li>\n<li><strong>Characteristic <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> features:</strong></li>\n</ul>\n<ul>\n<li><strong>CSF <span class=\"customMeta\" data-dictid=\"7aa38569251692777184021705e8de\">cleft</span> sign </strong>(thin layer of <span class=\"customMeta\" data-dictid=\"123c47549916927771854892334fb9\">CSF</span> around the mass)</li>\n<li>Cortical buckling</li>\n<li>Widening of the <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space with visible pial arteries/veins,</li>\n<li><strong>Hyperostosis</strong> or <span class=\"customMeta\" data-dictid=\"8f88b9c691169277718754ca072062\">erosion</span> of the calvarium.</li>\n<li><strong>Mother in law sign</strong><strong> </strong>(early <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> during the arterial phase and remain opacified long after the <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> phase has passed)</li>\n<li>Calcification</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Glioblastoma Multiforme </strong><strong>(Option A)</strong></td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA479\" data-author=\"\" data-hash=\"8329\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"404\" src=\"https://image.prepladder.com/notes/udWaTvLXquyYloIRAqnK1744190076.png\" width=\"400\"/></p>\n<ul>\n<li><strong>Glioblastomas</strong> are aggressive, poorly differentiated <strong>WHO <span class=\"customMeta\" data-dictid=\"d4ae50897e16927771884b5c46ba7d\">grade</span> 4</strong> astrocytic tumors</li>\n<li>It appears as <span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">heterogeneous</span> tumors with thick, <strong>irregular enhancing margins </strong>and<strong> central necrosis</strong>. They may also contain intratumoral vessels and hemorrhage.</li>\n<li>T2 signal abnormalities surrounding the tumor represent a mix of <span class=\"customMeta\" data-dictid=\"c8013ecf46169277720128cab0a7b4\">vasogenic</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> and infiltrating <span class=\"customMeta\" data-dictid=\"c82360aadd16927771936d67fa30a4\">neoplastic</span> cells.</li>\n<li>They can invade the <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> callosum,<strong> crossing </strong>the <strong>midline </strong>in a<strong> butterfly configuration</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Oligodendroglioma </strong><strong>(Option B)</strong></td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA480\" data-author=\"\" data-hash=\"8330\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"445\" src=\"https://image.prepladder.com/notes/rWGUY34HdH4aVDTlVejD1744190076.png\" width=\"600\"/></p>\n<ul>\n<li><strong>Oligodendroglioma </strong><strong>(Option B)</strong><strong>Oligodendrogliomas</strong> are <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> infiltrating glial tumors originating from oligodendrocytes and are characterized by <strong>IDH mutations</strong> and<strong> 1p/19q codeletion</strong>.</li>\n<li>These tumors can be either <strong>WHO <span class=\"customMeta\" data-dictid=\"d4ae50897e16927771884b5c46ba7d\">grade</span> 2</strong> (well-differentiated oligodendrogliomas) or <strong>WHO <span class=\"customMeta\" data-dictid=\"d4ae50897e16927771884b5c46ba7d\">grade</span> 3</strong> (anaplastic oligodendrogliomas).</li>\n<li>Typically occurs in the <strong>frontal lobe</strong>.</li>\n<li>They are slow-growing, non-encapsulated, and tend to <span class=\"customMeta\" data-dictid=\"8fd5e2898d16927771900855b98180\">infiltrate</span> the overlying<strong> cortex</strong>.</li>\n<li><strong>CT</strong>: Oligodendrogliomas are <span class=\"customMeta\" data-dictid=\"7f06e594de1692777190bfb4be030b\">isodense</span> to <span class=\"customMeta\" data-dictid=\"11309a56bc1692777189e89a8d3041\">hypodense</span> with<strong> calcification</strong></li>\n<li><strong>MRI</strong>: Tumors are <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> on T1 and <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> on T2. They generally do not enhance with contrast</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 27-year-old woman with a family history of an autosomal dominant genetic disorder presents with recurrent seizures and developmental delay. On physical examination, she has red papules on her face consistent with adenoma sebaceum. Which of the following is not a radiologic finding typically associated with this condition?", "options": [{"label": "A", "text": "Cortical tubers", "correct": false}, {"label": "B", "text": "Subependymal nodules", "correct": false}, {"label": "C", "text": "Sphenoid wing dysplasia", "correct": true}, {"label": "D", "text": "Lymphangioleiomyomatosis", "correct": false}], "correct_answer": "C. Sphenoid wing dysplasia", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/kRTFpSIOG1XkJf3PHIUF1744189678.png", "https://image.prepladder.com/notes/FinRMP9pJ3HNIsHhR1fR1744189680.png", "https://image.prepladder.com/notes/jmXfNSYdXxJJm3C53tnR1744189680.png", "https://image.prepladder.com/notes/skXnvzNWYvEKr3b6HzHL1744189681.png", "https://image.prepladder.com/notes/6YWKlZqrpUmIStSb7oac1744189681.png", "https://image.prepladder.com/notes/WJXUFv6Ykb50KhZYMeZD1744189682.png", "https://image.prepladder.com/notes/P8POs5c0YdJDo0wS9IXc1744189683.png", "https://image.prepladder.com/notes/ShzsAQlJ92V8dj4rRpEb1744189685.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old patient with a family history of an autosomal dominant condition was diagnosed with a mutation in chromosome 22 and advised to have an MRI every 2 years to monitor for tumors. An MRI scan was performed and shown below. Identify the radiological finding shown below that is most consistent with this chromosomal abnormality?", "options": [{"label": "A", "text": "Dural ectasia", "correct": false}, {"label": "B", "text": "Pilocytic astrocytomas", "correct": false}, {"label": "C", "text": "Vestibular schwannomas", "correct": true}, {"label": "D", "text": "Plexiform neurofibromas", "correct": false}], "correct_answer": "C. Vestibular schwannomas", "question_images": ["https://image.prepladder.com/notes/P2yC15ZaOpI7lP5Kljlf1744189084.png"], "explanation_images": ["https://image.prepladder.com/notes/LNaBbdWDl35WARUuJ2Zt1744189085.png", "https://image.prepladder.com/notes/XGE2HgIyMy0cUcdfBEI41744189085.png", "https://image.prepladder.com/notes/3EPAwQeDKyhnRr0AhGcd1744189086.png", "https://image.prepladder.com/notes/RmBRVtSjKKCBGCgqiLvW1744189086.png", "https://image.prepladder.com/notes/2dJU2FmxR2fC7w9noAkz1744189087.png", "https://image.prepladder.com/notes/XxLd1NH8vmN9eng1nKY51744189087.png", "https://image.prepladder.com/notes/69GNBTNZOL6ZyaH2fibD1744189088.png", "https://image.prepladder.com/notes/KqJBihs0ONRn6VfThK5V1744189088.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 2-week-old neonate is evaluated for failure to thrive and persistent tachycardia. A cranial MRI shows a large vascular malformation with multiple feeding arteries and a dilated vein of Galen. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Mural type Vein of Galen Malformation", "correct": false}, {"label": "B", "text": "Choroidal type Vein of Galen Malformation", "correct": true}, {"label": "C", "text": "Arteriovenous malformation", "correct": false}, {"label": "D", "text": "Developmental venous anomaly", "correct": false}], "correct_answer": "B. Choroidal type Vein of Galen Malformation", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/KX3wUo1xbIPKJpi5vQPK1744188775.png", "https://image.prepladder.com/notes/a1IUJo5gTrhleVmPdLSb1744188775.png", "https://image.prepladder.com/notes/sid4zHGMeS2botRLXmGT1744188776.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Vein of <span class=\"customMeta\" data-dictid=\"acec341aee169277718815f9172aba\">Galen</span> Malformation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA455\" data-author=\"\" data-hash=\"8305\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"800\" src=\"https://image.prepladder.com/notes/KX3wUo1xbIPKJpi5vQPK1744188775.png\" width=\"800\"/></p>\n<p>It is an <span class=\"customMeta\" data-dictid=\"3c19af349e16927771825f314a4a84\">arteriovenous</span> <span class=\"customMeta\" data-dictid=\"88900fc4c61692777191a66457050a\">malformation</span> (AVM) developing prenatally due to <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> connections (arteriovenous fistulas) involving the <strong>median prosencephalic vein</strong> which is a <span class=\"customMeta\" data-dictid=\"ae13cdc5c3169277719683e9f6bda5\">precursor</span> to the<strong> <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> of Galen.</strong></p>\n<ul>\n<li><strong>Types of VGM:</strong>\n<ul>\n<li><strong>Choroidal type </strong><strong>(Option B)</strong>\n<ul>\n<li><strong>Fed by multiple <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> arteries</strong> forming a <span class=\"customMeta\" data-dictid=\"00375928541692777193ce8621da42\">nidus</span> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> to the <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> varix.</li>\n<li>Presents in the <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> period with<strong> high-output heart failure</strong>.</li>\n</ul>\n</li>\n<li><strong>Mural type</strong><strong> (Option A)</strong>\n<ul>\n<li>Characterized by fewer, more defined <strong>fistulous connections </strong>within the wall of the <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> varix.</li>\n<li>Presents later in <span class=\"customMeta\" data-dictid=\"663d16ec8e169277719095f74c9816\">infancy</span> with symptoms such as<strong> hydrocephalus</strong>.</li>\n</ul>\n</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>The dilated <span class=\"customMeta\" data-dictid=\"979385c98a1692777192fb1721a16e\">median</span> prosencephalic <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> (MPV) appears as a fluid-filled, echo-free structure in the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> midline, showing significant <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> on <span class=\"customMeta\" data-dictid=\"eb476e70a316927771861ad68beaae\">Doppler</span> examination.</li>\n<li>On T2-weighted images, dilated <span class=\"customMeta\" data-dictid=\"11a5eea407169277720251b8446fa7\">feeding</span> and draining vessels appear as<strong> flow-voids</strong>.</li>\n<li>The primary treatment involves <span class=\"customMeta\" data-dictid=\"0dc32a9edf1692777187a82b199252\">endovascular</span> procedures.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Arteriovenous (AV) <span class=\"customMeta\" data-dictid=\"88900fc4c61692777191a66457050a\">malformation</span> </strong><strong>(Option C)</strong></td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA456\" data-author=\"\" data-hash=\"8306\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"800\" src=\"https://image.prepladder.com/notes/a1IUJo5gTrhleVmPdLSb1744188775.png\" width=\"800\"/></p>\n<ul>\n<li>AVM is an <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> <span class=\"customMeta\" data-dictid=\"aab33236e5169277720039a9437680\">tangle</span> of vessels connecting an <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> to a <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> without a normal <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> bed.</li>\n<li>Clinically present as <strong>Acute hemorrhage</strong>.</li>\n<li>AVMs consist of several components:</li>\n</ul>\n<ul>\n<li><strong>Feeding arteries</strong> â supply blood to the malformation</li>\n<li><strong>Nidus</strong> (meaning \"nest\") â the central part where <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> connections occur</li>\n<li><strong>Shunting arterioles</strong> â the main issue, causing direct <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> from arteries to veins</li>\n<li><strong>Interconnected <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> loops</strong></li>\n<li><strong>Draining veins</strong> â carry blood away from the malformation</li>\n</ul>\n<ul>\n<li>Early appearance of draining veins during the arterial phase of cerebral <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">angiography</span> indicates the presence of an <span class=\"customMeta\" data-dictid=\"3c19af349e16927771825f314a4a84\">arteriovenous</span> shunt.</li>\n<li>CECT shows a <strong>\"bag of worms\"</strong> appearance.</li>\n<li>Fast <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> creates<strong> flow voids </strong>visible on T2-weighted images.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Developmental <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"50a440f85816927771817d2fe50984\">anomaly</span> </strong><strong>(Option D)</strong></td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA457\" data-author=\"\" data-hash=\"8307\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/sid4zHGMeS2botRLXmGT1744188776.png\"/></p>\n<ul>\n<li>Congenital <span class=\"customMeta\" data-dictid=\"88900fc4c61692777191a66457050a\">malformation</span> of veins that drain the normal brain.</li>\n<li>It is the most common <span class=\"customMeta\" data-dictid=\"75a3b02a801692777184b9cb7f0c0a\">cerebrovascular</span> malformation.</li>\n<li><strong>\"Caput medusae\"</strong> sign (collection of dilated <span class=\"customMeta\" data-dictid=\"0a36e18386169277719259641cf29b\">medullary</span> veins converging into an enlarged <span class=\"customMeta\" data-dictid=\"1cc81ac19e1692777200e04c1cf5da\">transcortical</span> or <span class=\"customMeta\" data-dictid=\"3e782ca1981692777199a69e89b274\">subependymal</span> collector vein) is<strong> pathognomonic</strong> and is observed in the <strong>venous phase</strong> of <strong>angiography.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male presents with a 2-week history of worsening headache, fever, and progressive neurological deficits, including weakness in his right arm. He has no significant past medical history. On examination, he exhibits right-sided hemiparesis and mild confusion. Blood tests show mild leukocytosis. A CT image is given below. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Metastatic disease", "correct": false}, {"label": "B", "text": "Brain abscess", "correct": true}, {"label": "C", "text": "Neurocysticercosis", "correct": false}, {"label": "D", "text": "Lymphoma", "correct": false}], "correct_answer": "B. Brain abscess", "question_images": ["https://image.prepladder.com/notes/j1WkE7hNR3JH7RRYOnjD1744183459.png"], "explanation_images": ["https://image.prepladder.com/notes/2HXHcqzpk5tRpF73Uwue1744183460.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old patient presents with epilepsy and progressive memory loss over the past year. Neuroimaging reveals hippocampal volume loss and abnormal signal intensity on high-resolution coronal MRI. The internal laminated architecture of the hippocampus is disrupted. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Alzheimer's Disease", "correct": false}, {"label": "B", "text": "Mild Cognitive Impairment", "correct": false}, {"label": "C", "text": "Mesial Temporal Sclerosis (MTS)", "correct": true}, {"label": "D", "text": "Frontotemporal Dementia", "correct": false}], "correct_answer": "C. Mesial Temporal Sclerosis (MTS)", "question_images": ["https://image.prepladder.com/notes/5fO1dsn3WsovucJuydpa1744188239.png"], "explanation_images": ["https://image.prepladder.com/notes/oxJ95hUcnpfyjlTSUtKh1744188240.png", "https://image.prepladder.com/notes/hxK1kJbpums1TA3HZPxP1744188240.png", "https://image.prepladder.com/notes/nIMA2axuPxn1Y9T53X7K1744188241.png", "https://image.prepladder.com/notes/YTvWKn9ZGDHffnwtntDw1744188242.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:75%\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mesial <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> <span class=\"customMeta\" data-dictid=\"dae4dea0581692777198fdef9fa684\">sclerosis</span> (MTS)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\"><img alt=\"RA444\" data-author=\"\" data-hash=\"8294\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/oxJ95hUcnpfyjlTSUtKh1744188240.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>MTS primarily affects the<strong> hippocampus</strong>, a key region in the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> responsible for<strong> memory</strong>.</li>\n<li>Best visualized on<strong> high-resolution <span class=\"customMeta\" data-dictid=\"dad5b2152216927771851a3d10cd41\">coronal</span> MRI</strong> which demonstrates <strong>Hippocampa</strong>\n<ul>\n<li>Volume loss.</li>\n<li>Abnormal signal.</li>\n<li>Loss of normal internal <span class=\"customMeta\" data-dictid=\"1572de356e1692777191e5668d99d7\">laminated</span> architecture.</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>MTS may cause <strong>atrophy</strong> in the <span class=\"customMeta\" data-dictid=\"ca762506461692777190f12b43bb1a\">ipsilateral</span> <strong>mammillary body</strong> or <strong>fornix </strong>due to their connection within the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"fae243395d16927771917dbd1992e9\">limbic</span> (Papez) circuit.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\"><strong>Devicâs disease</strong></td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\"><img alt=\"RA445\" data-author=\"\" data-hash=\"8295\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/hxK1kJbpums1TA3HZPxP1744188240.png\"/></td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\">\n<ul>\n<li style=\"text-align:left\">Neuromyelitis optica (NMO) typically presents with <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">neuritis</span> and <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> myelitis, along with additional demyelination.</li>\n<li style=\"text-align:left\">It has overlapping clinical and radiographic features of multiple sclerosis.</li>\n<li style=\"text-align:left\">Antibodies involved in NMO target astrocyte<strong> aquaporin-4 </strong>channels, <span class=\"customMeta\" data-dictid=\"47fec911a316927771933b7607bdf0\">myelin</span> <span class=\"customMeta\" data-dictid=\"853eda0c8b16927771945a8590a405\">oligodendrocyte</span> glycoprotein, and neurofascin at the <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">node</span> of Ranvier.</li>\n<li style=\"text-align:left\">Spinal cord involvement typically presents as a <strong>high T2 signal</strong> that spans at least 3 vertebral segments, <span class=\"customMeta\" data-dictid=\"047f8930dd1692777197fed61e213c\">referred</span> to as a <strong>longitudinally extensive <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> cord lesion</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Multiple sclerosis</strong></td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top\">\n<p><img alt=\"RA446\" data-author=\"\" data-hash=\"8296\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"356\" src=\"https://image.prepladder.com/notes/nIMA2axuPxn1Y9T53X7K1744188241.png\" width=\"500\"/><img alt=\"RA447\" data-author=\"\" data-hash=\"8297\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"580\" src=\"https://image.prepladder.com/notes/YTvWKn9ZGDHffnwtntDw1744188242.png\" width=\"500\"/></p>\n<ul>\n<li>MS is considered an <strong>autoimmune disease</strong> with elevated<strong> antibodies to glial antigens</strong> (e.g., <span class=\"customMeta\" data-dictid=\"123c47549916927771854892334fb9\">CSF</span> <span class=\"customMeta\" data-dictid=\"754705a861169277719425d87c6742\">oligoclonal</span> bands).</li>\n<li>Optic <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">neuritis</span> is common in MS.</li>\n<li><strong>Dawson's fingers </strong>(lesions radiating perpendicularly from the <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> callosum), <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> lesions on <strong>T2-weighted </strong>and <strong>FLAIR images.</strong></li>\n<li>Hypointense<strong> \"black holes\" </strong>on <strong>T1-weighted </strong>images.</li>\n<li><strong>T1 C+ (Gadolinium): </strong>Active lesions enhance, often showing incomplete <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> <strong>(\"open ring sign\")</strong>.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:602px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>McDonald's</strong> criteria used for <strong>MS </strong>diagnosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dissemination in Space:</strong></p>\n<p>Requires T2 bright lesions in <strong>two or more</strong> of the following locations:</p>\n<ul>\n<li>Periventricular (âĽ3 lesions)</li>\n<li>Cortical or juxtacortical (âĽ1 lesion)</li>\n<li>Optic nerve (âĽ1 lesion)</li>\n<li>Infratentorial (âĽ1 lesion)</li>\n<li>Spinal cord (âĽ1 lesion)</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Dissemination in Time:</strong></p>\n<p>Established by:</p>\n<ul>\n<li>A new <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> on a follow-up scan</li>\n<li>A T2 bright or gadolinium-enhancing lesion</li>\n<li>An <span class=\"customMeta\" data-dictid=\"d1a9a79f701692777182066af09044\">asymptomatic</span> enhancing <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> with a non-enhancing T2 bright <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> on the same scan.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Primary Progressive <span class=\"customMeta\" data-dictid=\"eaea4028bf169277719371bd2eac9f\">Multiple Sclerosis</span> (PPMS):</strong></p>\n<p><strong>Requires:</strong></p>\n<ul>\n<li>âĽ1 year of disease progression</li>\n<li>Fulfillment of space dissemination criteria</li>\n</ul>\n<p><strong>Early Diagnosis:</strong></p>\n<ul>\n<li>Possible with clinically isolated syndrome and evidence of space dissemination on <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> or <strong>CSF-specific <span class=\"customMeta\" data-dictid=\"754705a861169277719425d87c6742\">oligoclonal</span> bands,</strong> without the need for time dissemination.</li>\n<li>Both <span class=\"customMeta\" data-dictid=\"509310d4411692777199f2ffdb7769\">symptomatic</span> and <span class=\"customMeta\" data-dictid=\"d1a9a79f701692777182066af09044\">asymptomatic</span> <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> lesions (excluding the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve) can be used for dissemination assessment.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old chronic alcoholic presents with symptoms of confusion, ataxia, and memory impairment. He has a history of Alcoholic Liver Disease. An MRI is ordered to assess any potential brain damage due to chronic alcohol abuse. The MRI reveals signaling abnormalities. Which of the following locations are likely to show abnormal signals? Locations: Mammillary bodies Periventricular grey matter Thalamus Corpus callosum Hippocampus", "options": [{"label": "A", "text": "1, 2, and 5", "correct": false}, {"label": "B", "text": "2, 3, and 4", "correct": false}, {"label": "C", "text": "1, 2, and 3", "correct": true}, {"label": "D", "text": "3, 4, and 5", "correct": false}], "correct_answer": "C. 1, 2, and 3", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zDzNczKCTEhsexu7nlop1744187453.png", "https://image.prepladder.com/notes/XWt3iGdRmh0UtRJsVxuv1744187454.png", "https://image.prepladder.com/notes/iuSMWYU3UWUDYfGgF5Nb1744187455.png", "https://image.prepladder.com/notes/dRKcpKqwi6GCfogsARo01744187456.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:673px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thiamine (Vitamin B1) <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> caused by chronic alcoholism, leading to impaired <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> and brain dysfunction, particularly in memory and <span class=\"customMeta\" data-dictid=\"3820ba101416927771858fe257e119\">coordination</span> areas.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mnemonic: </strong>GOA</p>\n<p><strong>G</strong>lobal Confusion: Mental disorientation, concentration issues, memory loss.</p>\n<p><strong>O</strong>phthalmoplegia:<strong> </strong>Paralysis or weakness of eye muscles, nystagmus, or double vision.</p>\n<p><strong>A</strong>taxia:<strong> </strong>Gait and stance disturbances due to cerebellar dysfunction.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Progression</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can lead to Wernicke-Korsakoff Syndrome, characterized by <span class=\"customMeta\" data-dictid=\"ee77d507701692777190bfcf47b497\">irreversible</span> memory deficits and confabulation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnostic Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Red Blood Cell <span class=\"customMeta\" data-dictid=\"c26dbc27621692777200e8790d9792\">Transketolase</span> Test: Assesses <span class=\"customMeta\" data-dictid=\"b70d1dbde516927772000d7774d2a5\">thiamine</span> deficiency.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>MRI Findings</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Signaling abnormalities seen in</p>\n<ul>\n<li><strong>Mammillary Bodies: </strong>Atrophy or hyperintensity.</li>\n<li><strong>Periventricular Gray Matter</strong></li>\n<li><strong>Thalamus.</strong></li>\n<li><strong>Midbrain Colliculi.</strong></li>\n<li><strong>Fornix involvement.</strong></li>\n</ul>\n<p><img alt=\"RA439\" data-author=\"\" data-hash=\"8289\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"490\" src=\"https://image.prepladder.com/notes/zDzNczKCTEhsexu7nlop1744187453.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:147px\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:526px\">\n<ul>\n<li><strong>Immediate <span class=\"customMeta\" data-dictid=\"b70d1dbde516927772000d7774d2a5\">Thiamine</span> Supplementation: </strong>Administer <span class=\"customMeta\" data-dictid=\"b70d1dbde516927772000d7774d2a5\">thiamine</span> (typically 100 mg IV or IM).</li>\n<li><strong>Glucose Infusion: </strong>After <span class=\"customMeta\" data-dictid=\"b70d1dbde516927772000d7774d2a5\">thiamine</span> is given, a glucose-containing solution can be infused, </li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare condition affecting chronic alcoholics, causing <strong>demyelination and <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> of the <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> callosum.</strong></p>\n<p>The mechanism is not fully understood, but it's <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to <span class=\"customMeta\" data-dictid=\"cbd2d1fd521692777191d00c1a4ede\">malnutrition</span> and chronic alcohol toxicity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cognitive Disturbances: </strong>Progressive dementia, confusion, memory loss.</p>\n<p><strong>Motor Symptoms: </strong>Seizures, <span class=\"customMeta\" data-dictid=\"053afdc7031692777187c2079a86a3\">gait</span> abnormalities, spasticity.</p>\n<p><strong>Altered Sensorium: </strong>Lethargy, stupor, or coma.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Progression</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can lead to severe cognitive impairment, spasticity, coma, or death. The condition may worsen rapidly or fluctuate over time.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>MRI Findings </strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hyperintense lesions on T2-weighted and FLAIR sequences in the <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> callosum, especially the body and splenium.</p>\n\t\t\t \n\n\t\t\t<p><strong>Signs: </strong></p>\n<p><strong>1. </strong>\"Butterfly-shaped\" lesions in the <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> callosum</p>\n<p><img alt=\"RA440\" data-author=\"\" data-hash=\"8290\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"300\" src=\"https://image.prepladder.com/notes/XWt3iGdRmh0UtRJsVxuv1744187454.png\" width=\"300\"/></p>\n<p><strong>2. Sandwich sign</strong></p>\n<p><img alt=\"RA441\" data-author=\"\" data-hash=\"8291\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"316\" src=\"https://image.prepladder.com/notes/iuSMWYU3UWUDYfGgF5Nb1744187455.png\" width=\"300\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:150px\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:518px\">\n<p>Thiamine and vitamin B-complex supplementation is usually administered.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:692px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Occurs due to rapid <span class=\"customMeta\" data-dictid=\"92a52a7756169277718538d58fe1a9\">correction</span> of chronic hyponatremia, leading to osmotic shifts and destruction of the <span class=\"customMeta\" data-dictid=\"47fec911a316927771933b7607bdf0\">myelin</span> <span class=\"customMeta\" data-dictid=\"44e9c0bbec169277719829907370ee\">sheath</span> in the central <span class=\"customMeta\" data-dictid=\"5e4684038e16927771967a14f73f37\">pons</span> and other areas (e.g., <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia).</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>Chronic alcoholics are at higher risk due to <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">electrolyte</span> imbalances.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Signs</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Piglet sign: </strong>Characteristic <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> pattern in the central pons.</li>\n<li><strong>Trident sign:</strong> <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> hallmark resembling a trident, indicating myelinolysis.</li>\n</ul>\n<p><img alt=\"RA442\" data-author=\"\" data-hash=\"8292\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"316\" src=\"https://image.prepladder.com/notes/dRKcpKqwi6GCfogsARo01744187456.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:182px\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:510px\">\n<ul>\n<li><strong>Altered Sensorium:</strong> Ranges from confusion and <span class=\"customMeta\" data-dictid=\"40f8eaa3d01692777186cb3e1d6c69\">disorientation</span> to <span class=\"customMeta\" data-dictid=\"4aa0c051dd16927771993f76e966b0\">stupor</span> or coma.</li>\n<li><strong>Quadriparesis:</strong> Severe weakness in all four limbs.</li>\n<li><strong>Rapid Deterioration:</strong> Symptoms can progress quickly, leading to <span class=\"customMeta\" data-dictid=\"e39842f67b1692777184171cd1852a\">coma</span> or death if untreated.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:182px\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:510px\">\n<p>Slow <span class=\"customMeta\" data-dictid=\"92a52a7756169277718538d58fe1a9\">correction</span> of sodium levels in chronic <span class=\"customMeta\" data-dictid=\"44b22766411692777189eb80d6416e\">hyponatremia</span> is essential to avoid ODS.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Assertion: The absence of the swallow tail on MRI is indicative of Parkinson's disease. Reason: It represents the characteristic loss of dopamine-producing neurons in the substantia nigra, leading to specific changes in the brain's morphology.", "options": [{"label": "A", "text": "Both the assertion and reason are true, and the reason correctly explains the assertion.", "correct": true}, {"label": "B", "text": "Both the assertion and reason are true, but the reason does not correctly explain the assertion.", "correct": false}, {"label": "C", "text": "The assertion is true, but the reason is false.", "correct": false}, {"label": "D", "text": "The assertion is false, but the reason is true.", "correct": false}], "correct_answer": "A. Both the assertion and reason are true, and the reason correctly explains the assertion.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/1tyTJOP73drSFGZtMxZo1744186844.png", "https://image.prepladder.com/notes/I51LjiEIw4EAyv2NSf9s1744186846.png", "https://image.prepladder.com/notes/a2g8UgxxgaJ6PvoAausV1744186848.png", "https://image.prepladder.com/notes/c8HtTfQQT7ugcF55IZcg1744186850.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following diseases and their associated radiological signs Radiological Sign Disease 1) Giant Panda sign a) Ceruloplasmin Defeciency 2) tram track calcification b) Fahrâs Disease 3) Eye of the tiger sign c) Sturge Weber syndrome 4) Bracket Calcification d) Hallervorden-Spatz disease", "options": [{"label": "A", "text": "1-a, 2-c, 3-d, 4-b", "correct": true}, {"label": "B", "text": "1-c, 2-b, 3-a, 4-d", "correct": false}, {"label": "C", "text": "1-b, 2-d, 3-c, 4-a", "correct": false}, {"label": "D", "text": "1-d, 2-a, 3-c, 4-b", "correct": false}], "correct_answer": "A. 1-a, 2-c, 3-d, 4-b", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zbDqcCEUWKvvrXv5b4xT1744186525.png", "https://image.prepladder.com/notes/D2AufnHyssz5KNLChA9W1744186525.png", "https://image.prepladder.com/notes/MgDt6xc2KOAhjRMj4ctP1744186530.png", "https://image.prepladder.com/notes/tglVJH9mYj590scRfZrU1744186530.png", "https://image.prepladder.com/notes/FwPQNtFOxeh2FE5EJb5k1744186531.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:75%\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Wilsonâs Disease</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Genetic disorder leading to low levels of ceruloplasmin, impairing <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> transport and resulting in <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> accumulation.</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI: </strong>\"Face of the giant panda\" sign in the midbrain; signal abnormalities in <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> <span class=\"customMeta\" data-dictid=\"f2804c808516927771887dda93e56c\">ganglia</span> due to <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> deposits.</p>\n<img alt=\"RA425\" data-author=\"\" data-hash=\"8275\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/zbDqcCEUWKvvrXv5b4xT1744186525.png\"/>\n<p><strong>KF ring: </strong>Golden-brown ring in the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> due to <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> accumulation.</p>\n<p><img alt=\"RA426\" data-author=\"\" data-hash=\"8276\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/D2AufnHyssz5KNLChA9W1744186525.png\"/></p>\n<p><strong>Note: </strong></p>\n<p><strong>Sarcoidosis: </strong></p>\n<p>Gallium scan: Distinctive \"panda sign\" showing <span class=\"customMeta\" data-dictid=\"887a04d130169277720091d7c1eeea\">tracer</span> <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> in the lacrimal, parotid, and salivary glands.</p>\n<p>This should not be confused with the panda sign of Wilson's disease seen on MRI.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Hallervorden-Spatz Disease (PKAN)</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Iron accumulation in the brain, especially the <span class=\"customMeta\" data-dictid=\"86c230abe316927771889bbef8df5d\">globus</span> pallidus.</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI:</strong> \"Eye of the tiger\" sign on T2-weighted imaging. Central <span class=\"customMeta\" data-dictid=\"6873f1dcce16927771890fcdc546b0\">hyperintense</span> gliotic area surrounded by <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> iron deposits, resembling a tiger's eye.</p>\n<p><img alt=\"RA427\" data-author=\"\" data-hash=\"8277\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/MgDt6xc2KOAhjRMj4ctP1744186530.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Fahrâs Disease (Basal <span class=\"customMeta\" data-dictid=\"f2804c808516927771887dda93e56c\">Ganglia</span> Calcification)</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Idiopathic or secondary to <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> disorders (e.g., hypoparathyroidism).</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT scan:</strong> <span class=\"customMeta\" data-dictid=\"d963da62eb16927771993737a99c7c\">Symmetrical</span> calcifications in the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia, thalamus, <span class=\"customMeta\" data-dictid=\"e0c09f9e461692777185212f4de159\">dentate</span> nucleus, and other brain structures.</p>\n<p>Bracket calcifications: Curvilinear hyperdensities forming a bracket-like appearance around the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia.</p>\n<p><img alt=\"RA428\" data-author=\"\" data-hash=\"8278\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/tglVJH9mYj590scRfZrU1744186530.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Sturge-Weber Syndrome</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Congenital <span class=\"customMeta\" data-dictid=\"d64938bfc81692777193fb87a47c80\">neurocutaneous</span> disorder with <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> malformations.</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT scan: </strong>\"Tram-track\" calcifications along the <span class=\"customMeta\" data-dictid=\"f46588d97c16927771882c69136596\">gyri</span> of the cerebral cortex, especially in the <span class=\"customMeta\" data-dictid=\"77dc7a0ab81692777194dba7ab78ab\">occipital</span> and <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> lobes.</p>\n<p><strong>MRI: </strong>Cortical <span class=\"customMeta\" data-dictid=\"97ff5253fb169277718224c7b0faf8\">atrophy</span> and leptomeningeal enhancement.</p>\n<img alt=\"RA429\" data-author=\"\" data-hash=\"8279\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/FwPQNtFOxeh2FE5EJb5k1744186531.png\"/></td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:700px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hypoparathyroidism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Leads to chronic <span class=\"customMeta\" data-dictid=\"59f10ee7c31692777189a8544bb404\">hypocalcemia</span> and can cause <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> in the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> <span class=\"customMeta\" data-dictid=\"f2804c808516927771887dda93e56c\">ganglia</span> due to <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> imbalance.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Familial <span class=\"customMeta\" data-dictid=\"4acddc3cf5169277718996440e2e14\">Idiopathic</span> Cerebral <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">Calcification</span> (Fahr's syndrome)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A genetic condition characterized by <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> calcifications in the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia.</p>\n<p><strong>Bracket calcifications: </strong>Curvilinear hyperdensities forming a bracket-like appearance around the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Perinatal Hypoxia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lack of oxygen during or immediately after birth can result in <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> in the brain, including the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carbon <span class=\"customMeta\" data-dictid=\"03077f6c8716927771923763487a9e\">Monoxide</span> Intoxication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Exposure leads to <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> calcifications in the <span class=\"customMeta\" data-dictid=\"86c230abe316927771889bbef8df5d\">globus</span> pallidus, affecting neurological function.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lead Poisoning</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic exposure can result in various neurological symptoms, including calcifications.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cockayne Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A genetic disorder leading to <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> in the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> <span class=\"customMeta\" data-dictid=\"f2804c808516927771887dda93e56c\">ganglia</span> among other symptoms.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An 80-year-old male presents to his physician with complaints of difficulty sleeping and frequently waking up during the night. He denies any accompanying symptoms, such as pain, anxiety, or other disturbances. Concerned about his sleep issues, the physician orders an MRI scan of the brain. The MRI findings reveal an appearance commonly referred to as \"brain sand.\" Based on the findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Choroid plexus calcification", "correct": false}, {"label": "B", "text": "Pineal gland calcification", "correct": true}, {"label": "C", "text": "Falx cerebri calcification", "correct": false}, {"label": "D", "text": "Basal ganglia calcification", "correct": false}], "correct_answer": "B. Pineal gland calcification", "question_images": ["https://image.prepladder.com/notes/WLjhTEBXglmVOdqFafwU1744185059.png"], "explanation_images": ["https://image.prepladder.com/notes/0YqJuk84yApJ8tS4kMTm1744185062.png", "https://image.prepladder.com/notes/1H5rdG5mDFy9M8NiZ6tt1744185063.png", "https://image.prepladder.com/notes/j1ecIMiydJZQn7aZr4Aw1744185063.png", "https://image.prepladder.com/notes/VkIrRqIjWmrkBQXv4OHJ1744185064.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:75%\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Site </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Physiological Function</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Pineal Calcification</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Posterior to the third ventricle</p>\n<img alt=\"RA421\" data-author=\"\" data-hash=\"8271\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/0YqJuk84yApJ8tS4kMTm1744185062.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Known as <strong>\"brain sand\"</strong> (corpora arenacea); increases with age.</p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Involved in <strong>melatonin production</strong> and regulation of <strong>circadian rhythms.</strong></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Choroid <span class=\"customMeta\" data-dictid=\"3a9085a5761692777195417d7c03ae\">Plexus</span> Calcification</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lateral ventricles</p>\n<p><img alt=\"RA422\" data-author=\"\" data-hash=\"8272\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/1H5rdG5mDFy9M8NiZ6tt1744185063.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Benign <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> that <strong>produces <span class=\"customMeta\" data-dictid=\"99a9bf133e1692777184ec4b1011fe\">cerebrospinal</span> fluid</strong> (CSF); often a normal finding with age.</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Responsible for <span class=\"customMeta\" data-dictid=\"123c47549916927771854892334fb9\">CSF</span> production.</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Falx <span class=\"customMeta\" data-dictid=\"5a4a970c4b1692777184108b0b09c8\">Cerebri</span> Calcification</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Midline of the brain</p>\n<p><img alt=\"RA423\" data-author=\"\" data-hash=\"8273\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/j1ecIMiydJZQn7aZr4Aw1744185063.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Calcification along the <strong>sickle-shaped fold of <span class=\"customMeta\" data-dictid=\"826ce1571f1692777186a0b6e02559\">dura</span> mater; </strong>common <span class=\"customMeta\" data-dictid=\"c13872f9e3169277718001d2a0f063\">aging</span> change.</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">No specific <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> role; considered a normal <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> change.</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Basal <span class=\"customMeta\" data-dictid=\"f2804c808516927771887dda93e56c\">Ganglia</span> Calcification</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Globus pallidus and surrounding areas</p>\n<p><img alt=\"RA424\" data-author=\"\" data-hash=\"8274\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/VkIrRqIjWmrkBQXv4OHJ1744185064.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common in elderly individuals; not usually associated with neurological impairment.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Associated with <span class=\"customMeta\" data-dictid=\"c13872f9e3169277718001d2a0f063\">aging</span> processes</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 2-month-old infant is brought to the clinic with persistent jaundice, hepatosplenomegaly, petechiae, and microcephaly. On further evaluation, the infant is found to have sensorineural hearing loss and signs of developmental delay. The mother reports a history of a flu-like illness during pregnancy. A CT scan of the infant's brain reveals the following findings. Based on these findings, which of the following is the most likely causative agent?", "options": [{"label": "A", "text": "Rubella", "correct": false}, {"label": "B", "text": "Toxoplasma gondii", "correct": false}, {"label": "C", "text": "Zika virus", "correct": false}, {"label": "D", "text": "Cytomegalovirus (CMV)", "correct": true}], "correct_answer": "D. Cytomegalovirus (CMV)", "question_images": ["https://image.prepladder.com/notes/vXcYdKYE4U2rtRGABW091744184807.png"], "explanation_images": ["https://image.prepladder.com/notes/vXcYdKYE4U2rtRGABW091744184807.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:703px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Infection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Calcification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Affected Brain Region</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Congenital <span class=\"customMeta\" data-dictid=\"d47433201516927772009cacb59295\">Toxoplasmosis</span> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diffuse or <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> intracranial</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Basal ganglia, cerebral cortex</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hydrocephalus, chorioretinitis, developmental delays</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Congenital <span class=\"customMeta\" data-dictid=\"ee831318721692777185479e65655e\">Cytomegalovirus</span> (CMV)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Periventricular calcifications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Periventricular region</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microcephaly, <span class=\"customMeta\" data-dictid=\"a646a25d3616927771989c6e155498\">sensorineural</span> hearing loss, developmental abnormalities</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Congenital Zika Virus</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Punctate calcifications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cortical/subcortical regions</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microcephaly, brain malformations, joint contractures</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Congenital <span class=\"customMeta\" data-dictid=\"b8aa1ffb8916927771976438d71d1b\">Rubella</span> (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Punctate calcifications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cortical/subcortical regions</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microcephaly, cataracts, deafness, heart defects</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:660px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A type of <span class=\"customMeta\" data-dictid=\"faffdfe705169277720242bf7ee9b5\">white matter</span> brain injury affecting <span class=\"customMeta\" data-dictid=\"84f13673191692777196762b18e036\">premature</span> infants, characterized by the death of small areas of brain tissue around the ventricles due to ischemia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Premature birth (especially before 32 weeks of gestation)</li>\n<li>Low birth weight</li>\n<li>Neonatal infections</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Periventricular area (white matter near the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> ventricles of the brain)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ischemia (lack of blood flow)</li>\n<li>Infection or <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> during <span class=\"customMeta\" data-dictid=\"faffdfe705169277720242bf7ee9b5\">white matter</span> development</li>\n<li>Maternal infections or severe <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> distress</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Premature infants (underdeveloped brain) â <span class=\"customMeta\" data-dictid=\"faffdfe705169277720242bf7ee9b5\">White matter</span> (myelinated nerve fibers) is <span class=\"customMeta\" data-dictid=\"55691242bb1692777199360f64cb67\">susceptible</span> to damage â <span class=\"customMeta\" data-dictid=\"0f670d10711692777190af4b12fac9\">Ischemia</span> (reduced blood flow) and <span class=\"customMeta\" data-dictid=\"a249eeb5551692777189661d39c1b2\">hypoxia</span> (low oxygen levels) â Injury and destruction of oligodendrocytes â Impaired <span class=\"customMeta\" data-dictid=\"47fec911a316927771933b7607bdf0\">myelin</span> formation â Inadequate <span class=\"customMeta\" data-dictid=\"0976e2c25c16927771931e9ddacda8\">myelination</span> â Deficits in motor function and other neurological impairments.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Early signs may include <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> muscle tone (hypotonia, spasticity) and <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> movements.</li>\n<li>Developmental delays.</li>\n<li>Cerebral <span class=\"customMeta\" data-dictid=\"f3e67cebd51692777194f5257898e4\">palsy</span> (leading to <span class=\"customMeta\" data-dictid=\"1ce806f0111692777198eedf1b5824\">spastic</span> diplegia).</li>\n<li>Possible cognitive impairments, including intellectual disabilities and visual disturbances.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neuroimaging:</strong></p>\n<ul>\n<li><strong>Cranial Ultrasound:</strong> Detects brain abnormalities in <span class=\"customMeta\" data-dictid=\"84f13673191692777196762b18e036\">premature</span> infants.</li>\n<li><strong>MRI:</strong> Gold standard for identifying PVL, showing <span class=\"customMeta\" data-dictid=\"faffdfe705169277720242bf7ee9b5\">white matter</span> damage.</li>\n<li><strong>CT Scans:</strong> May detect calcifications but are less sensitive than MRI.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Supportive care:</strong> Focuses on symptom management and optimizing development.</li>\n<li><strong>Rehabilitation: </strong>Includes physical therapy, occupational therapy, and speech therapy.</li>\n<li><strong>Medications:</strong> May include antispasmodics for <span class=\"customMeta\" data-dictid=\"86b057bddf1692777198e020fc1aad\">spasticity</span> management.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prognosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Varies widely; some children experience mild developmental delays, while others may have severe disabilities such as cerebral palsy.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old man with a history of HIV presents to the emergency department with new-onset seizures and altered mental status. His CD4 count is 80 cells/mmÂł. A brain MRI is performed to evaluate for potential infections and is as shown below. What is the diagnosis?", "options": [{"label": "A", "text": "Herpes simplex", "correct": false}, {"label": "B", "text": "Japanese encephalitis", "correct": false}, {"label": "C", "text": "Cryptococcosis", "correct": false}, {"label": "D", "text": "Toxoplasmosis", "correct": true}], "correct_answer": "D. Toxoplasmosis", "question_images": ["https://image.prepladder.com/notes/qrClsnShabs5QeTxgAZe1744184617.png"], "explanation_images": ["https://image.prepladder.com/notes/BBKRiwvC16Yq6xOCN15D1744184618.png", "https://image.prepladder.com/notes/kM0Z8BDIzyEpl0OePQku1744184618.png", "https://image.prepladder.com/notes/plfNyBO10p0TSNu1WZgO1744184618.png", "https://image.prepladder.com/notes/q9A3T4C5fKV2ew33lqId1744184619.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old male presents with recurrent seizures. MRI imaging reveals as follows: Based on the MRI findings, which stage of neurocysticercosis is most consistent with this presentation?", "options": [{"label": "A", "text": "Granular nodular stage", "correct": false}, {"label": "B", "text": "Vesicular stage", "correct": true}, {"label": "C", "text": "Colloidal vesicular stage", "correct": false}, {"label": "D", "text": "Calcified nodular stage", "correct": false}], "correct_answer": "B. Vesicular stage", "question_images": ["https://image.prepladder.com/notes/efDZzVs8HwDxEp4c9Gwa1744184066.png"], "explanation_images": ["https://image.prepladder.com/notes/eXs8hEZ9z1gS0Dj2poAh1744184067.png", "https://image.prepladder.com/notes/DRM3cPNfFs0S6k0DFRnX1744184067.png", "https://image.prepladder.com/notes/A4vjyCkfDoh6fxAe0jwN1744184067.png", "https://image.prepladder.com/notes/6wlalJWLe4YsnzkbMYqy1744184068.png", "https://image.prepladder.com/notes/D79lSpazSrR3aFeQWX8J1744184069.png", "https://image.prepladder.com/notes/daZAKujrRROgANtnsu0m1744184071.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:70%\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neurocysticercosis</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Neurocysticercosis is the most critical <span class=\"customMeta\" data-dictid=\"c0433f52ad1692777194c2ffb6fc63\">parasitic</span> disease of the central nervous system (CNS) globally.</li>\n<li>It is caused by the <span class=\"customMeta\" data-dictid=\"ff500c480516927771879044cce9bf\">encysted</span> <span class=\"customMeta\" data-dictid=\"c2907c9f0016927771914eedf733dd\">larvae</span> of the <span class=\"customMeta\" data-dictid=\"a4b3ac874d16927772008f9446d140\">tapeworm</span> <em>Taenia solium</em>, transmitted through:\n\t\t\t\t<ul>\n<li>Ingesting eggs from undercooked pork</li>\n<li>Fecal-oral transmission between humans</li>\n</ul>\n</li>\n<li>Larvae are spread to neural, muscular, and <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> tissues via the bloodstream.</li>\n<li>The symptoms typically appear around 5 years after initial infection and are non-specific; 50%â70% of patients present with epilepsy.</li>\n<li>Larvae can <span class=\"customMeta\" data-dictid=\"eb32e458601692777190ed974ab329\">infect</span> the brain parenchyma, <span class=\"customMeta\" data-dictid=\"0a5d82eeef169277719934b86fb07b\">subarachnoid</span> space, and ventricles. The most common <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> is parenchymal, followed by intraventricular. Mixed types may also occur.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Stages of Parenchymal Neurocysticercosis</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" rowspan=\"1\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vesicular stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>Viable <span class=\"customMeta\" data-dictid=\"48bab7934a16927771917c5a2bf7e2\">larva</span> with a <strong>scolex </strong>(worm head).</li>\n<li>Cysts have thin walls, minimal enhancement, and no surrounding edema.</li>\n<li>Cyst fluid resembles <span class=\"customMeta\" data-dictid=\"99a9bf133e1692777184ec4b1011fe\">cerebrospinal</span> fluid (CSF) and allows unrestricted water diffusion.</li>\n<li>The <strong>scolex </strong>may appear <strong>hyperintense </strong>on <strong>T1</strong>, <strong>FLAIR</strong>, and <strong>DWI </strong>images.</li>\n</ul>\n<img alt=\"RA408\" data-author=\"\" data-hash=\"8258\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/eXs8hEZ9z1gS0Dj2poAh1744184067.png\"/></td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Colloidal <span class=\"customMeta\" data-dictid=\"4b0fee14c816927772016e67cf3a13\">vesicular</span> stage </strong><strong>(Option C)</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>Larva begins to break down, triggering an immune response.</li>\n<li>Characterized by <strong>ring-enhancing lesions</strong>, <strong>perilesional edema</strong>, and<strong> mass effect</strong>.</li>\n<li><strong>Cyst content </strong>becomes more proteinaceous, appearing <strong>hyperintense </strong>on <strong>T1 </strong>and <strong>FLAIR </strong>images.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Granular <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> stage</strong> <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>As the <span class=\"customMeta\" data-dictid=\"48bab7934a16927771917c5a2bf7e2\">larva</span> dies, the <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> collapses, leading to <strong>thick enhancing <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> walls </strong>and <strong>increased surrounding edema</strong>.</li>\n</ul>\n<img alt=\"RA409\" data-author=\"\" data-hash=\"8259\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/DRM3cPNfFs0S6k0DFRnX1744184067.png\"/>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Calcified <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> stage </strong><strong>(Option D)</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>Represents the inactive <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of neurocysticercosis.</li>\n<li>Edema resolves, revealing <strong>small calcified lesions </strong>(2â10 mm in diameter).</li>\n<li>Contrast <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> and <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> are rare but can occur during <strong>seizure activity</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Intraventricular cysticercosis</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>The second most common form, with <span class=\"customMeta\" data-dictid=\"c2907c9f0016927771914eedf733dd\">larvae</span> more frequently located in the third and fourth ventricles.</li>\n<li>Can obstruct <span class=\"customMeta\" data-dictid=\"123c47549916927771854892334fb9\">CSF</span> flow, potentially causing <strong>hydrocephalus</strong>, which may present acutely.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Subarachnoid cysticercosis</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>Involves areas such as <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> cisterns, <span class=\"customMeta\" data-dictid=\"c76557c9e1169277719955ac4ecac7\">Sylvian</span> fissures, and <span class=\"customMeta\" data-dictid=\"d96ff08a3316927771845ceebabe4b\">cerebellopontine</span> angles.</li>\n</ul>\n<strong>Racemose <span class=\"customMeta\" data-dictid=\"183a3f89521692777185a6d0144d6c\">cysticercosis</span> </strong>is a rare <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> characterized by multiple clustered cysts separated by septae, resembling a <strong>âbunch of grapes,â</strong> and can cause significant local meningeal enhancement.</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male, an HIV-positive patient, presents with fever, headache, and confusion for the past week. Neurological examination reveals neck stiffness and altered mental status. CT shows basal meningeal enhancement and hydrocephalus. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Tuberculomas", "correct": false}, {"label": "B", "text": "Tuberculous meningitis", "correct": true}, {"label": "C", "text": "Cerebritis", "correct": false}, {"label": "D", "text": "Miliary tuberculosis", "correct": false}], "correct_answer": "B. Tuberculous meningitis", "question_images": ["https://image.prepladder.com/notes/GliUJ6SElTnQ0w1aLRGy1744183696.png"], "explanation_images": ["https://image.prepladder.com/notes/GliUJ6SElTnQ0w1aLRGy1744183696.png", "https://image.prepladder.com/notes/yvYLXnrepnNwgZVaBE8s1744183697.png", "https://image.prepladder.com/notes/SVN3pKY4AhajHitYPWEq1744183726.png", "https://image.prepladder.com/notes/Wqt18dFFmVPVrOGpb8DA1744183698.png", "https://image.prepladder.com/notes/3gznKKpgNrLDiKrGk3OW1744183698.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Tuberculous meningitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA402\" data-author=\"\" data-hash=\"8252\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"532\" src=\"https://image.prepladder.com/notes/GliUJ6SElTnQ0w1aLRGy1744183696.png\" width=\"400\"/></p>\n<ul>\n<li>Tuberculous <span class=\"customMeta\" data-dictid=\"7d8f74eaae16927771928214d10c17\">meningitis</span> is the most frequent <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> manifestation.</li>\n<li>Early disease shows<strong> <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> leptomeningeal enhancement</strong>; later stages typically involve the<strong> <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> leptomeninges</strong>, especially in the <span class=\"customMeta\" data-dictid=\"f750c43ccf1692777190a4366e99a0\">interpeduncular</span> cistern.</li>\n</ul>\n<p><strong>Imaging Findings</strong>:</p>\n<ul>\n<li><strong>CT Findings</strong>:\n\n\t\t\t\t<ul>\n<li><strong>Obliteration of <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> cisterns</strong> due to isoattenuating or hyperattenuating exudate.</li>\n<li>Sensitive indicators: <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">linear</span> <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> of middle cerebral <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> cisterns, <span class=\"customMeta\" data-dictid=\"e5922b669a169277719487f8bbabd3\">obliteration</span> of <span class=\"customMeta\" data-dictid=\"123c47549916927771854892334fb9\">CSF</span> spaces, Y-shaped <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> at the suprasellar/middle cerebral <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> junction, and asymmetric enhancement.</li>\n<li>Hydrocephalus is common at diagnosis.</li>\n</ul>\n</li>\n<li><strong>MRI Advantages</strong>:\n\t\t\t\t<ul>\n<li>Greater sensitivity for detecting<strong> <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> meningeal enhancement</strong>, hydrocephalus, and infarcts in <span class=\"customMeta\" data-dictid=\"5afc9732fd1692777195b9482bf3c2\">perforator</span> territories.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Intracranial Tuberculomas </strong><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\">\n<p><img alt=\"RA403\" data-author=\"\" data-hash=\"8253\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"480\" src=\"https://image.prepladder.com/notes/yvYLXnrepnNwgZVaBE8s1744183697.png\" width=\"400\"/></p>\n<p style=\"text-align:left\">Most commonly found at the <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> of white and grey matter.</p>\n<p style=\"text-align:left\"><strong>CT Appearance</strong>:</p>\n<ul>\n<li style=\"text-align:left\">Present as small, rounded lesions <span class=\"customMeta\" data-dictid=\"b6c1ec53a916927771905dd3089104\">iso</span> or <span class=\"customMeta\" data-dictid=\"7b396b336f16927771894ed574ed88\">hypo</span> attenuating to normal brain tissue with variable surrounding <span class=\"customMeta\" data-dictid=\"c8013ecf46169277720128cab0a7b4\">vasogenic</span> edema.</li>\n<li style=\"text-align:left\">Homogeneous contrast <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> in solid lesions; rim <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> indicates central <span class=\"customMeta\" data-dictid=\"314062f48b1692777183ce9d1142a3\">caseation</span> or liquefaction.</li>\n<li style=\"text-align:left\">The \"target sign\" (central high <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> with rim enhancement) is not <span class=\"customMeta\" data-dictid=\"32b854324a1692777185c6c79fdc99\">definitive</span> for tuberculomas.</li>\n</ul>\n<p style=\"text-align:left\"><strong>MRI Characteristics</strong>:</p>\n<ul>\n<li style=\"text-align:left\">Small, non-caseated tuberculomas exhibit low signal intensity on T1 and high signal on T2 sequences.</li>\n<li style=\"text-align:left\">Caseation leads to low signal intensity on T2.</li>\n<li style=\"text-align:left\">On DWI, tuberculomas may show either elevated or restricted diffusion.</li>\n<li style=\"text-align:left\"><strong>MR Spectroscopy</strong> shows a prominent <strong>lipid peak </strong>at 1.3ppm</li>\n</ul>\n<p><img alt=\"RA404\" data-author=\"\" data-hash=\"8256\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"400\" src=\"https://image.prepladder.com/notes/SVN3pKY4AhajHitYPWEq1744183726.png\" width=\"400\"/></p>\n<p style=\"text-align:left\"> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Miliary <span class=\"customMeta\" data-dictid=\"8d98ce2d3616927772013bfc3e0528\">Tuberculosis</span> </strong><strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA405\" data-author=\"\" data-hash=\"8254\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"445\" src=\"https://image.prepladder.com/notes/Wqt18dFFmVPVrOGpb8DA1744183698.png\" width=\"350\"/></p>\n\t\t\tCharacterized by multiple small (&lt;5 mm) enhancing granulomas scattered throughout the brain, which may calcify over time.</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>TB Abscess</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"RA406\" data-author=\"\" data-hash=\"8255\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"290\" src=\"https://image.prepladder.com/notes/3gznKKpgNrLDiKrGk3OW1744183698.png\" width=\"500\"/></p>\n<ul>\n<li>Single <span class=\"customMeta\" data-dictid=\"2517cc6a98169277719963641fc715\">supratentorial</span> <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> at the<strong> grayâwhite matter interface</strong>.</li>\n<li>CT appearance: <strong>hyperdense rim</strong> with<strong> low-density center</strong>.</li>\n<li>MRI appearance: <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> wall slightly T1-hyperintense and T2-hypointense; central contents are T1 <span class=\"customMeta\" data-dictid=\"9912c2745b1692777189895dadd770\">hypointense</span> and T2 hyperintense, with <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> dense wall <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> and significant <span class=\"customMeta\" data-dictid=\"11181a4ee0169277719515c3680afc\">perilesional</span> edema.</li>\n<li>More common in elderly and <span class=\"customMeta\" data-dictid=\"a3cc9f976916927771895692a1a8a0\">immunocompromised</span> individuals; larger than tuberculomas, often multiloculated, with thicker <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> enhancement</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:592px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Peak and Metabolite</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Normal Function</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lipid (1.3 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Marker of tissue necrosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tuberculosis, Glioblastoma, Cerebral infarction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>N-Acetylaspartate (NAA, 2.0 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Marker of neuronal health and density</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Canavan Disease, Alzheimerâs, Gliomas</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Choline (Cho, 3.2 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reflects cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> turnover</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tumors, Demyelinating diseases, <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">Hepatic</span> encephalopathy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Creatine (Cr, ~3.0 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Energy <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> marker</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Variable (often stable marker)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lactate (1.3 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anaerobic <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> marker</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypoxia, Stroke, Mitochondrial Disorders</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Myo-inositol (~3.5 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Osmoregulation and glial cell marker</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alzheimerâs, Meningiomas, <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">Hepatic</span> encephalopathy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acetate &amp; <span class=\"customMeta\" data-dictid=\"cf0e807d031692777199f6fd7c6afd\">Succinate</span> (~2.0 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intermediate metabolites in <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> processes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bacterial abscesses, <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">Metabolic</span> disorders</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Taurine (~3.4 ppm)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Osmoregulation, <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> salt conjugation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pediatric brain tumors (e.g., medulloblastoma)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 33 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Identify the hemorrhage shown in the following image?", "options": [{"label": "A", "text": "Extradural hemorrhage", "correct": false}, {"label": "B", "text": "Intraparenchymal hemorrhage", "correct": false}, {"label": "C", "text": "Subarachnoid hemorrhage", "correct": false}, {"label": "D", "text": "Subdural hemorrhage", "correct": true}], "correct_answer": "D. Subdural hemorrhage", "question_images": ["https://image.prepladder.com/content/IT287kXc88atk5UR7DuJ1747373649.png"], "explanation_images": ["https://image.prepladder.com/content/xgvKuc2fFuB7l6lf8Kro1747373685.png", "https://image.prepladder.com/content/9EKXZYiRoScuOJ1snjO01747373685.png", "https://image.prepladder.com/content/sX1YGmbby6V7S9ySqu1R1747373685.png", "https://image.prepladder.com/notes/lJeoLNI3XjpHiVc3pE5C1747656925.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:900px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Extradural <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">Hemorrhage</span> (EDH) (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Subdural <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">Hemorrhage</span> (SDH) </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Type of Hemorrhage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Arterial Hemorrhage</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Venous Hemorrhage</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Shape</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Biconvex or lentiform</p>\n<p> </p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Gaillard F, Abu Kamesh M, Worsley C\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/extradural-haemorrhage\" data-tags=\"\" height=\"440\" src=\"https://image.prepladder.com/content/xgvKuc2fFuB7l6lf8Kro1747373685.png\" width=\"392\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Crescent or sickle-shaped</p>\n<p> </p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"James Heilman, MD\" data-hash=\"\" data-license=\"CC BY-SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Subdural_hematoma\" data-tags=\"\" height=\"439\" src=\"https://image.prepladder.com/content/9EKXZYiRoScuOJ1snjO01747373685.png\" width=\"353\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Limited by sutures; can cross the midline</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Follows the brain surface; crosses sutures, does not cross midline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rupture of the middle meningeal <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (MMA)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rupture of <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> <span class=\"customMeta\" data-dictid=\"ec4db08de51692777183e82739c83d\">bridging</span> veins</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Onset of Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Often presents with a <span class=\"customMeta\" data-dictid=\"10b50278251692777191a626ee1604\">lucid</span> interval</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Symptoms may develop gradually, often without a <span class=\"customMeta\" data-dictid=\"10b50278251692777191a626ee1604\">lucid</span> interval</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Force Required</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Requires more force; associated with adjacent bony rupture</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Can occur with trivial trauma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Midline Crossing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Can cross the midline</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Does not cross the midline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lucid Interval</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Yes; patient appears normal before deterioration</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>No; deterioration may be more gradual</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Symptoms may include headache, loss of consciousness, and <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> neurological deficits</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Symptoms may include headache, confusion, and potential <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> deficits</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the condition that presents with an empty delta sign.", "options": [{"label": "A", "text": "Subarachnoid hemorrhage", "correct": false}, {"label": "B", "text": "Subdural hemorrhage", "correct": false}, {"label": "C", "text": "Cerebral venous thrombosis", "correct": true}, {"label": "D", "text": "Intraparenchymal hemorrhage", "correct": false}], "correct_answer": "C. Cerebral venous thrombosis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Wr8hgFTZZKSmHCGIcmE41747657360.png", "https://image.prepladder.com/content/JoT8aMjjXkkVMh1uETdy1747375038.png", "https://image.prepladder.com/content/T9i5ONMAwUtWQ5OLsVH41747375038.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which imaging technique is preferred for diagnosing primary hyperparathyroidism in a woman who presented with confusion, constipation, and headache, and has elevated serum calcium (13.1 mg/dL) and ALP levels?", "options": [{"label": "A", "text": "MRI", "correct": false}, {"label": "B", "text": "FDG PET", "correct": false}, {"label": "C", "text": "CT", "correct": false}, {"label": "D", "text": "Sestamibi scan", "correct": true}], "correct_answer": "D. Sestamibi scan", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/2zxxHIc7sV490dh9xcyh1745573875.png", "https://image.prepladder.com/content/lSm9sRH9M7CoYfvTXW7t1745573875.png", "https://image.prepladder.com/content/qjwLFOm26LyZTxLgX9BY1745573875.png", "https://image.prepladder.com/content/TC9mTT7MoaOEKdavJAw01745573875.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:900px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Image</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Subperiosteal erosions and <span class=\"customMeta\" data-dictid=\"16b76d1d1c1692777200240efcb0e2\">terminal</span> <span class=\"customMeta\" data-dictid=\"797daba8ca1692777197dc9f8d3a4a\">resorption</span> in the <span class=\"customMeta\" data-dictid=\"27cd397275169277719513776c38c8\">phalanges</span> (usually starts in the middle <span class=\"customMeta\" data-dictid=\"e9451cd23d1692777195fe471f486e\">phalanx</span> of the index finger's <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> side) </strong>along with bone demineralisation.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jones J, Chieng R, Vadera S, et al. \" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/subperiosteal-bone-resorption\" data-tags=\"\" height=\"211\" src=\"https://image.prepladder.com/content/2zxxHIc7sV490dh9xcyh1745573875.png\" width=\"303\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>The \"salt and pepper\" appearance, or pepper pot skull</strong> (lytic lesions in the skull).</p>\n<p> </p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Niknejad M, Bell D, Gaillard F, et al.\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/salt-and-pepper-sign-skull-1\" data-tags=\"\" height=\"181\" src=\"https://image.prepladder.com/content/lSm9sRH9M7CoYfvTXW7t1745573875.png\" width=\"271\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Brown tumour or <span class=\"customMeta\" data-dictid=\"dc4ced4b86169277719422ad2689a5\">osteitis</span> fibrosa cystica:</strong> <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">Cystic</span> lesions in bone from excessive <span class=\"customMeta\" data-dictid=\"fc8c28347a16927771945680bd00be\">osteoclastic</span> <span class=\"customMeta\" data-dictid=\"797daba8ca1692777197dc9f8d3a4a\">resorption</span> appear as low-density, multiloculated cysts that can lead to bone expansion, accompanied by <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> and <span class=\"customMeta\" data-dictid=\"09e414c5a71692777188ef029aefe5\">granulation</span> tissue.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Frank Gaillard\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Brown_tumor\" data-tags=\"\" height=\"218\" src=\"https://image.prepladder.com/content/qjwLFOm26LyZTxLgX9BY1745573875.png\" width=\"242\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Sestamibi scan (Tc-99): Localize the tumour</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\" Mostafa Elfeky\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/tc-99m-sestamibi\" data-tags=\"\" height=\"173\" src=\"https://image.prepladder.com/content/TC9mTT7MoaOEKdavJAw01745573875.png\" width=\"324\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A young woman, aged 18, has come forward with seizures. Her radiological image is provided below. Considering that the MR spectroscopy of the affected area revealed increased levels of choline, alanine, and lactate, what is the probable medical condition she is facing?", "options": [{"label": "A", "text": "Cerebral toxoplasmosis", "correct": false}, {"label": "B", "text": "Neurocysticercosis", "correct": true}, {"label": "C", "text": "Cryptococcosis", "correct": false}, {"label": "D", "text": "Multiple tuberculomas", "correct": false}], "correct_answer": "B. Neurocysticercosis", "question_images": ["https://image.prepladder.com/content/3lddeeaTmEEb7ftIsYiH1745841712.png"], "explanation_images": ["https://image.prepladder.com/content/MhOl165Evm5mU63GsCIQ1745841814.png", "https://image.prepladder.com/content/vJAb2IUUCp0HU7QfMgWx1745841837.png", "https://image.prepladder.com/content/U88w1gyFWJpg0yJ7AOew1745841849.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Seizures, headaches, <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> neurological deficits</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vesicular, Colloidal, Granular, Nodular-calcified</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cystic lesions with \"dot sign,\" ring enhancement, or calcifications</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MR Spectroscopy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased <strong>choline, alanine, lactate</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Albendazole + Steroids Âą Antiepileptics</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 14 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 62-year-old female with a history of hypertension and diabetes presents to the emergency department with new-onset chest pain and fatigue. An electrocardiogram shows ST-segment changes suggestive of ischemia. Which scan type should be prioritized in this case?", "options": [{"label": "A", "text": "Thallium scan", "correct": true}, {"label": "B", "text": "Pyrophosphate scan", "correct": false}, {"label": "C", "text": "MUGA scan", "correct": false}, {"label": "D", "text": "PET scan", "correct": false}], "correct_answer": "A. Thallium scan", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/jkaHHAbD4NYMrkOxqpy21744098328.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:618px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Purpose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Scan types</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>For Myocardial <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">Perfusion</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Assess ischemia</li>\n<li><strong>Cold spot: </strong>decreased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> in ischemic areas.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Thallium scan (Commonly used)</li>\n<li>Tetrofosmin</li>\n<li>Sestamibi scan.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>For Myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">Infarction</span> </strong><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Assess infarct</li>\n<li><strong>Hot spot</strong> in <span class=\"customMeta\" data-dictid=\"7d8fbc62391692777190399f2b0126\">infarct</span> area as <span class=\"customMeta\" data-dictid=\"53da8f40b5169277719620504e0cb9\">pyrophosphate</span> accumulates and is not metabolized.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>99m Tc - <span class=\"customMeta\" data-dictid=\"53da8f40b5169277719620504e0cb9\">Pyrophosphate</span> scan.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>For <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">Ventricular</span> Function </strong><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Evaluate <span class=\"customMeta\" data-dictid=\"3b69bda4d21692777187109c85a27e\">ejection</span> fraction</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li><strong>MUGA</strong> (Multiple Gated Acquisition) scan (AKA nuclear ventriculography)\n\t\t\t\t<ul>\n<li>Radiolabeled RBCs are used</li>\n</ul>\n</li>\n<li>Most accurate for <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> function - <strong>Cardiac MRI</strong></li>\n</ul>\n<br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>For Myocardial <span class=\"customMeta\" data-dictid=\"a8dece102f16927772026b199f06af\">Viability</span> </strong></p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Assess the <span class=\"customMeta\" data-dictid=\"a8dece102f16927772026b199f06af\">viability</span> of myocardium</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li><strong>PETscan </strong>- Best investigation for myocardial viability.\n\t\t\t\t<ul>\n<li><strong>Perfusion</strong> and<strong> <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> mismatch</strong> are observed in the PET scan.</li>\n<li><strong>Perfusion Agents</strong>:N-13 <span class=\"customMeta\" data-dictid=\"edbc0adbb31692777181ed0ee792d4\">ammonia</span> and <span class=\"customMeta\" data-dictid=\"1ec57c04b9169277719713f09a6baa\">Rubidium</span> chloride.</li>\n<li><strong>Metabolism Agent</strong>:</li>\n</ul>\n</li>\n</ul>\n<p>FDG-PET is used for <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> metabolism.</p>\n<ul>\n<li>No FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> indicates a <strong>normal heart</strong> or an<strong> infarct.</strong></li>\n<li>FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> is present: In the <strong>Ischemic Myocardium</strong></li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>FDG-PET is combined with <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> for comprehensive assessment.\n\t\t\t\t<ul>\n<li>Uptake in PET with low <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> indicates <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> (suggestive of <strong>hibernation</strong>).</li>\n<li>Irreversible <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> indicates the presence of <strong>scar tissue</strong>.</li>\n</ul>\n</li>\n<li><strong>Note:</strong> <span class=\"customMeta\" data-dictid=\"dcb9435e1b1692777189d9971e1279\">Hibernating myocardium</span> is ischemic but viable.</li>\n</ul>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n\t\t\t </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old man has metastatic castration-resistant prostate cancer (mCRPC). Which of the following agents would be most suitable for palliative treatment?", "options": [{"label": "A", "text": "Phosphorus-32", "correct": false}, {"label": "B", "text": "Radium-223", "correct": true}, {"label": "C", "text": "Electron beams", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Radium-223", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Agents</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Photon beams</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>External beam radiation therapy</li>\n<li>Made up of high energy:\n\t\t\t\t<ul>\n<li>X-rays (LINAC- <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">Linear</span> accelerators)</li>\n<li>Gamma rays</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Proton beams</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Positively charged particles</li>\n<li>Bragg peak</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Electron beams </strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Negative charged particles.</li>\n<li>Skin tumors located superficially (they canât travel deeply into tissue)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radium-223 <span class=\"customMeta\" data-dictid=\"bf6fd2cd021692777186ba5a7c93b1\">dichloride</span> (223Ra)</strong><strong> (Optin B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bone <span class=\"customMeta\" data-dictid=\"ee33485c641692777192b16b999489\">metastases</span> in metastatic castration-resistant <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">prostate</span> cancer (mCRPC)</li>\n<li>Chemical similarity to calcium</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Strontium-89 (89Sr)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Beta emitter</li>\n<li>Painful metastatic castrate-resistant <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">prostate</span> cancer</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Samarium-153</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Beta emitters</li>\n<li>Osseous <span class=\"customMeta\" data-dictid=\"ee33485c641692777192b16b999489\">metastases</span> for primary osteosarcomas</li>\n<li>Osteosarcoma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phosphorus-32</strong><strong> (Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Beta emitters</li>\n<li>Chronic <span class=\"customMeta\" data-dictid=\"258737f45016927771931e053a03d1\">myelogenous</span> leukemia</li>\n<li>Polycythemia vera</li>\n<li>Epithelial tumors (ovarian)</li>\n<li>Craniopharyngioma</li>\n<li>Primary <span class=\"customMeta\" data-dictid=\"85bd8b2ec816927771958f9ebe3568\">pericardial</span> tumors- <span class=\"customMeta\" data-dictid=\"8a0b36beb6169277719466e16c52d7\">palliative</span> therapy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Iodine 131</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Beta and <span class=\"customMeta\" data-dictid=\"49be0416121692777188dc8944b7bc\">gamma</span> emitters</li>\n<li>Thyroid cancers: Follicular, papillary, and HĂźrthle cell carcinoma</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TIk4vDSboaTCMd352N6g1746433286.mp3", "video": ""}, {"text": "A 65-year-old patient with a history of smoking undergoes a positron emission tomography (PET) scan for suspected lung cancer. The scan shows increased radiotracer uptake in the right lung. However, further investigation reveals no malignancy. Which of the following is the most likely cause of this false positive result?", "options": [{"label": "A", "text": "Low metabolic activity of the tumor", "correct": false}, {"label": "B", "text": "Physiological uptake due to muscle activity", "correct": false}, {"label": "C", "text": "Small size of the tumor", "correct": false}, {"label": "D", "text": "Inflammation from a recent pneumonia infection", "correct": true}], "correct_answer": "D. Inflammation from a recent pneumonia infection", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:574px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inflammation and Infection</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Conditions like pneumonia, sarcoidosis, and infections (e.g., tuberculosis) cause increased FDG uptake.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Post-Surgical Changes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inflammatory responses post-surgery may yield false positives if scans are done too soon.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Benign Tumors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> can occur in <span class=\"customMeta\" data-dictid=\"1bbae82f1f16927771824f797639fa\">benign</span> lesions like granulomas or abscesses.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Physiological Uptake</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal activities (muscle use, <span class=\"customMeta\" data-dictid=\"a3a5f97a071692777183981a3570fc\">brown fat</span> metabolism) may <span class=\"customMeta\" data-dictid=\"efaf9e0192169277719278711f7f74\">mimic</span> malignancy. <strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:574px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">Metabolic</span> Activity Tumors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cancers like bronchioalveolar <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">carcinoma</span> may show minimal FDG uptake. <strong>(Option A ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Small Tumors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tumors smaller than <span class=\"customMeta\" data-dictid=\"723fdec66b1692777186e92f0c6fdf\">detection</span> thresholds may be missed. <strong>(Option C ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Timing of Scans</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Timing relative to treatment affects uptake; treated tumors may show <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> FDG levels despite <span class=\"customMeta\" data-dictid=\"915ca56f53169277720296a38e3e8e\">viable</span> cancer.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male patient diagnosed with nasopharyngeal carcinoma (NPC) is being considered for radiotherapy. Which of the following statements regarding the radiosensitivity of NPC is correct?", "options": [{"label": "A", "text": "Low radiosensitivity, high failure rates.", "correct": false}, {"label": "B", "text": "Highly radiosensitive; 70% to 98% control with IMRT.", "correct": true}, {"label": "C", "text": "EMT promotes radiosensitivity.", "correct": false}, {"label": "D", "text": "High RPA1 expression indicates sensitivity.", "correct": false}], "correct_answer": "B. Highly radiosensitive; 70% to 98% control with IMRT.", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiosensitive Tumors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radioresistant Tumors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Response to Radiation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High; significant <span class=\"customMeta\" data-dictid=\"8f8e685bad16927771985cfaa5810f\">shrinkage</span> or eradication</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low; treatment often fails</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NPC, HPV-positive <span class=\"customMeta\" data-dictid=\"b1a011ab5416927771949dde193e3a\">oropharyngeal</span> carcinoma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glioblastomas, certain breast cancers, NPC (subset)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Mechanisms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Immune <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> (CD8+ T cells)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gene expression (e.g., <em>RPA1</em>), EMT</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Often responsive to <span class=\"customMeta\" data-dictid=\"a75f060aa1169277719777dd69df3f\">radiotherapy</span> alone or with chemo</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Requires tailored strategies (e.g., targeted biomarkers)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following factors is most likely associated with increased radiosensitivity in tumor cells?", "options": [{"label": "A", "text": "Efficient DNA double-strand break (DSB) repair mechanisms", "correct": false}, {"label": "B", "text": "Low apoptosis rates in response to radiation", "correct": false}, {"label": "C", "text": "High levels of Îł-H2AX foci indicating unrepaired DNA damage", "correct": true}, {"label": "D", "text": "High proportion of cancer stem cells (CSCs) within the tumor", "correct": false}], "correct_answer": "C. High levels of Îł-H2AX foci indicating unrepaired DNA damage", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:587px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Factor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiosensitive Tumors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radioresistant Tumors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DNA Repair Efficiency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Poor repair (e.g., high Îł-H2AX)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Efficient repair mechanisms</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Apoptosis Rates</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High (e.g., <span class=\"customMeta\" data-dictid=\"32599f889a169277719169e3483e62\">lymphoid</span> tumors)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low apoptotic response</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Immune Activation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High immune activation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low immune activation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cancer Stem Cells</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fewer CSCs, more OCCs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Higher proportion of CSCs</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male is undergoing fractionated radiotherapy for the treatment of a large head and neck tumor. The radiation oncologist opts for a standard fractionation schedule. Which of the following principles is not part of the \"5 Rs of Radiobiology\" that underlie the rationale for fractionation?", "options": [{"label": "A", "text": "Radiosensitivity", "correct": false}, {"label": "B", "text": "Repair", "correct": false}, {"label": "C", "text": "Radioresistance", "correct": true}, {"label": "D", "text": "Reoxygenation", "correct": false}], "correct_answer": "C. Radioresistance", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Technique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Spatially Fractionated Radiation Therapy (SFRT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Delivers <span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">heterogeneous</span> doses to spare normal tissue, effective in bulky tumors.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hyperfractionation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>More frequent, smaller doses to enhance local control.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Accelerated Fractionation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Shortens overall treatment time, maintaining or enhancing efficacy.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male with localized prostate cancer is referred for radiotherapy. The oncologist wants to use a technique that provides superior dose conformity to the tumor, reduces treatment time, and limits radiation exposure to surrounding healthy tissues. Which of the following radiotherapy techniques would be most appropriate for this patient?", "options": [{"label": "A", "text": "VMAT", "correct": true}, {"label": "B", "text": "IGRT", "correct": false}, {"label": "C", "text": "CyberKnife", "correct": false}, {"label": "D", "text": "NCT", "correct": false}], "correct_answer": "A. VMAT", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/FXjdejtf7mcLRAGMkaEG1744099727.png", "https://image.prepladder.com/notes/rKh1MCGSiflJQXCBvhpi1744099760.png", "https://image.prepladder.com/notes/V9XnLMZdx99d8hrawvJG1744099774.png", "https://image.prepladder.com/notes/50cgfz3nkbS8MoLTSGQL1744099786.png", "https://image.prepladder.com/notes/9oDZJ6oXzXL96v1MQwg61744099800.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:489px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Technique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Efficiency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Precision</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>OAR Sparing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment Time</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>VMAT</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Good</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Short</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IGRT</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Variable</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Very High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Excellent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Variable</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CyberKnife</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Very High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Excellent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Long</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NCT</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Good</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Variable</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old patient with a lung tumor is undergoing radiation therapy. The radiation oncologist decides to implement a gating technique to minimize damage to surrounding healthy tissue. What is the primary advantage of using gating for this patient?", "options": [{"label": "A", "text": "It shapes the radiation dose to match the tumor's irregular shape.", "correct": false}, {"label": "B", "text": "It prevents the tumor from moving during treatment by immobilizing the patient.", "correct": false}, {"label": "C", "text": "It directs radiation beams from different angles to target the tumor.", "correct": false}, {"label": "D", "text": "Synchronizes radiation delivery with the tumor's position during the respiratory cycle.", "correct": true}], "correct_answer": "D. Synchronizes radiation delivery with the tumor's position during the respiratory cycle.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/McHXh64r3NjxeST5LHlO1744099547.png", "https://image.prepladder.com/notes/uBnnQowjMKcUnSTcVlXf1744099564.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 9-year-old patient is undergoing proton therapy for a localized brain tumor located near critical structures like the optic nerve and brainstem. The radiation oncologist uses proton therapy to take advantage of the Bragg peak. What is the primary benefit of using proton therapy with the Bragg peak in this scenario?", "options": [{"label": "A", "text": "Uniform radiation delivery to both the tumor and surrounding brain tissues.", "correct": false}, {"label": "B", "text": "Deliver the highest dose of radiation at the tumor site while sparing the optic nerve and brainstem.", "correct": true}, {"label": "C", "text": "Greater radiation scatter, which is ideal for treating tumors near critical structures.", "correct": false}, {"label": "D", "text": "Photon therapy provides better tissue sparing than proton therapy.", "correct": false}], "correct_answer": "B. Deliver the highest dose of radiation at the tumor site while sparing the optic nerve and brainstem.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/QQxhMHlBUeQ8DkxBWUjz1744099326.png", "https://image.prepladder.com/notes/r3iOcYnfkzQKmkfINNB81744099339.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the image, applicators have been placed on a 58-year-old woman who is undergoing high-dose interstitial brachytherapy for early-stage breast cancer. Which of the following advantages does afterloading provide in this scenario?", "options": [{"label": "A", "text": "Eliminates the need for imaging confirmation before placing the radioactive seeds.", "correct": false}, {"label": "B", "text": "Minimizes radiation exposure to healthcare workers during seed placement.", "correct": true}, {"label": "C", "text": "It enhances the mobility of radioactive seeds for more uniform dose distribution.", "correct": false}, {"label": "D", "text": "Allows for real-time radiation delivery without the use of encapsulated seeds.", "correct": false}], "correct_answer": "B. Minimizes radiation exposure to healthcare workers during seed placement.", "question_images": ["https://image.prepladder.com/notes/UNYPddgwryZdAE8EdzYl1744099151.png"], "explanation_images": ["https://image.prepladder.com/notes/UNYPddgwryZdAE8EdzYl1744099151.png", "https://image.prepladder.com/notes/pgHOWbGGNbxsC6njJuzA1744099165.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xLHEEAleyOITA06GFKim1747150884.mp3", "video": ""}, {"text": "Which of the following statements is NOT true regarding the use of linear accelerators (LINAC) in radiotherapy?", "options": [{"label": "A", "text": "The X-ray beam used for treatment is generated by an overhead X-ray tube.", "correct": false}, {"label": "B", "text": "LINACs do not require the use of radioisotopes for radiation production.", "correct": false}, {"label": "C", "text": "LINACs are commonly used in brachytherapy procedures.", "correct": true}, {"label": "D", "text": "Microwave energy is used to accelerate electrons within the LINAC.", "correct": false}], "correct_answer": "C. LINACs are commonly used in brachytherapy procedures.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/YGCvZ7L951J8vsjDEDpF1744098994.png", "https://image.prepladder.com/notes/pIF38EPsNHHXeITpRJn91744099008.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "External beam radiation therapy is planned for a 58-year-old woman with a diagnosis of superficial basal cell carcinoma on her forehead as she refused surgical intervention Considering the characteristics of various radiation modalities, which type of beam would be the most appropriate for achieving effective treatment while minimizing damage to the underlying tissues?", "options": [{"label": "A", "text": "X-ray", "correct": false}, {"label": "B", "text": "Photon beams", "correct": false}, {"label": "C", "text": "Electron beams", "correct": true}, {"label": "D", "text": "Gamma rays", "correct": false}], "correct_answer": "C. Electron beams", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:589px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Types of Beams</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Electrons </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Negatively charged particles</li>\n<li>Limited penetration</li>\n<li>Effective for tumors near the body surface (Skin tumors)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Photons </strong><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Can reach deep tumors</li>\n<li>Scatter radiation along the path</li>\n<li>Continue through normal tissue after reaching the tumor</li>\n<li>Made up of high energy:\n\t\t\t\t<ul>\n<li>X-rays (LINAC- <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">Linear</span> accelerators) <strong>(Option A ruled out)</strong></li>\n<li>Gamma rays <strong>(Option D ruled out)</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Protons</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Positively charged particles</li>\n<li>No radiation scatter</li>\n<li>Stop precisely at the tumor location</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>cobalt 60 (Co</strong><strong><sub>60</sub></strong><strong>)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Linear accelerator</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"e3555f448716927771844820d69cfa\">Cobalt</span> machine produces an artificial <span class=\"customMeta\" data-dictid=\"4dd949a23a1692777197a5627fa8d8\">radioisotope</span> (Co )</li>\n<li>Advantage: Relative <span class=\"customMeta\" data-dictid=\"a4d5e86b6416927771850468afd1ba\">constancy</span> of beam output</li>\n<li>Source replacement approximately every 4 to 5 years</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>LINAC- <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">Linear</span> accelerators do not need a radioisotope</li>\n<li>The fast-moving <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> beam generates radiation which is used in radiotherapy</li>\n<li>X-ray beams are produced</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following best describes the Warburg effect in cancer cells?", "options": [{"label": "A", "text": "Cancer cells prefer oxidative phosphorylation under anaerobic conditions", "correct": false}, {"label": "B", "text": "Tumor cells primarily use glycolysis even in the presence of oxygen", "correct": true}, {"label": "C", "text": "Lactate production occurs only under hypoxic conditions in tumors", "correct": false}, {"label": "D", "text": "Mitochondrial function is absent in cancer cells", "correct": false}], "correct_answer": "B. Tumor cells primarily use glycolysis even in the presence of oxygen", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aerobic Glycolysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cancer cells rely heavily on glycolysis, increasing <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> and 18F-FDG uptake, even with oxygen.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Transport &amp; Trapping</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GLUT-1 transporters mediate <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> entry. 18F-FDG is phosphorylated and trapped inside cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tumor Heterogeneity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Differences in tumor subtype, size, and <span class=\"customMeta\" data-dictid=\"3728deb0881692777192af3b093774\">microvasculature</span> affect 18F-FDG uptake.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Implication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prognostic Indicator</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Higher 18F-FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> correlates with <strong>worse prognosis</strong> (e.g., shorter DFS in <span class=\"customMeta\" data-dictid=\"1c5272ad3d1692777190e71409d07a\">invasive</span> ductal carcinoma).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reverse Warburg Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cancer-associated fibroblasts (CAFs) increase <span class=\"customMeta\" data-dictid=\"185a500ee91692777188b3044db06d\">glycolysis</span> in tumor cells via <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> coupling.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment Monitoring</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PET <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> tracks changes in 18F-FDG uptake, reflecting <strong>therapy responses</strong> <span class=\"customMeta\" data-dictid=\"e4865847fa169277720044d7b530b0\">targeting</span> <span class=\"customMeta\" data-dictid=\"185a500ee91692777188b3044db06d\">glycolysis</span> or mitochondria.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old man with a suspicion of lung cancer is being evaluated with an FDG PET scan to guide his treatment plan. Which of the following is NOT a typical use of FDG PET in clinical practice?", "options": [{"label": "A", "text": "Evaluating the presence of distant metastasis from the primary lung tumor", "correct": false}, {"label": "B", "text": "Differentiating between benign inflammatory conditions and malignant lesions", "correct": true}, {"label": "C", "text": "Assessing the effectiveness of chemotherapy", "correct": false}, {"label": "D", "text": "Staging the extent of lung cancer prior to treatment", "correct": false}], "correct_answer": "B. Differentiating between benign inflammatory conditions and malignant lesions", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/quiQSozM0qMgqxfyOhBw1744098851.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 63-year-old man with a 20-year history of chronic hepatitis B presents with worsening fatigue and right upper quadrant pain. On examination, hepatomegaly is noted. Recent liver function tests show elevated ALT and AST, with normal bilirubin levels. An abdominal ultrasound reveals a 4 cm hypoechoic liver mass in the right lobe, prompting further evaluation. A sulfur colloid scan is performed, revealing a focal defect in hepatic uptake with normal splenic and bone marrow uptake. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Hepatic hemangioma", "correct": false}, {"label": "B", "text": "Hepatocellular carcinoma", "correct": true}, {"label": "C", "text": "Focal nodular hyperplasia", "correct": false}, {"label": "D", "text": "Hepatic cyst", "correct": false}], "correct_answer": "B. Hepatocellular carcinoma", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 42-year-old woman presents with intermittent right upper quadrant pain, nausea, and vomiting. A HIDA scan is performed, and the image is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic cholecystitis", "correct": false}, {"label": "B", "text": "Acute cholecystitis", "correct": true}, {"label": "C", "text": "Bile leak", "correct": false}, {"label": "D", "text": "Gallbladder dyskinesia", "correct": false}], "correct_answer": "B. Acute cholecystitis", "question_images": ["https://image.prepladder.com/notes/6lavClY7q7hy0bBIoBaK1744098561.png"], "explanation_images": ["https://image.prepladder.com/notes/Od2iTsGWn4WtWOmuqfAk1744098576.png", "https://image.prepladder.com/notes/6lavClY7q7hy0bBIoBaK1744098561.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Disease/Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Findings</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute <span class=\"customMeta\" data-dictid=\"180ce1a7c416927771844825c616f4\">cholecystitis</span> </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Non-visualisation of the gallbladder</li>\n<li>Hot rim sign- <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> around the gallbladder</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chronic <span class=\"customMeta\" data-dictid=\"180ce1a7c416927771844825c616f4\">cholecystitis</span> </strong><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Visualization is <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> or delayed (due to contracted gallbladder)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gallbladder <span class=\"customMeta\" data-dictid=\"aa971a0b1c169277718621174b6657\">dyskinesia</span> </strong><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Low <span class=\"customMeta\" data-dictid=\"1f51bf91811692777188d929c8e851\">gallbladder</span> <span class=\"customMeta\" data-dictid=\"3b69bda4d21692777187109c85a27e\">ejection</span> fraction</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Others</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bile leaks</li>\n<li>Biliary <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> (patency of the intra- and <span class=\"customMeta\" data-dictid=\"85d0636fae1692777187fc93c80934\">extrahepatic</span> <span class=\"customMeta\" data-dictid=\"7dd6eda7ce169277718325f22de9e8\">biliary</span> system)</li>\n<li>Patency of a <span class=\"customMeta\" data-dictid=\"da02568ca41692777183e1212be55c\">bilioenteric</span> anastomosis.</li>\n<li>Biliary atresia</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 42-year-old woman presents with concerns about a lump on her neck that she first noticed approximately three weeks ago. A scan was performed as shown in the image. Which of the following is incorrect for this scan?", "options": [{"label": "A", "text": "I-123 is the most commonly used", "correct": false}, {"label": "B", "text": "There is an increased uptake of tracer in one area", "correct": true}, {"label": "C", "text": "99mTc-sestamibi can be used for this scan", "correct": false}, {"label": "D", "text": "Half-life of the most common tracer is 13.2 hours", "correct": false}], "correct_answer": "B. There is an increased uptake of tracer in one area", "question_images": ["https://image.prepladder.com/notes/caTSe532W2AAZ6XAvMr41744097463.png"], "explanation_images": ["https://image.prepladder.com/notes/N1Uyemza1N3KaldcWen71744097480.png", "https://image.prepladder.com/notes/2yYwqrcpAqvxdjhHWIcN1744097573.png", "https://image.prepladder.com/notes/1u8XOgt6AH5EWhQaqun71744097586.png", "https://image.prepladder.com/notes/G4xU2H1JTe0ov0JAu16s1744097788.png", "https://image.prepladder.com/notes/cgSQIDrnIcjC54k37B501744097817.png", "https://image.prepladder.com/notes/FuszTwpeb1gs3o1jmLy21744097834.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:574px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Isotope</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Half-Life</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Type of Emission</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Iodine-127</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Stable</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Natural iodine, essential for <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> function</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Not radioactive</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Iodine-123</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>13.2 hours<strong> (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Diagnostic imaging</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Gamma rays</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Iodine-125</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>60.14 days</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Brachytherapy (permanent implant)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Gamma rays</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Iodine-131</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>8.04 days</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Radioablation of thyroid</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Beta and <span class=\"customMeta\" data-dictid=\"49be0416121692777188dc8944b7bc\">gamma</span> rays</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:622px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Radioactive <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">Iodine</span> Uptake</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>RAIUS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Normal Nodule</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Normal appearance of a <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> <span class=\"customMeta\" data-dictid=\"6e6233ba551692777193c62c40bd5f\">nodule</span> on a <span class=\"customMeta\" data-dictid=\"f391426a781692777197a16039bb5e\">radioactive</span> <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> scan.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Normal uptake</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><img alt=\"RAIU-Normal Nodule\" data-author=\"\" data-hash=\"8185\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/N1Uyemza1N3KaldcWen71744097480.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hot Nodule</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> of <span class=\"customMeta\" data-dictid=\"f391426a781692777197a16039bb5e\">radioactive</span> <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">iodine</span> in one <span class=\"customMeta\" data-dictid=\"6e6233ba551692777193c62c40bd5f\">nodule</span> compared to surrounding tissue.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Increased uptake</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Hot Nodule-RAIU\" data-author=\"Frank Gaillard\" data-hash=\"8186\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/thyroid-nodule-autonomous\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/2yYwqrcpAqvxdjhHWIcN1744097573.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Cold Nodule</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Decreased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> of <span class=\"customMeta\" data-dictid=\"f391426a781692777197a16039bb5e\">radioactive</span> <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">iodine</span> in one <span class=\"customMeta\" data-dictid=\"6e6233ba551692777193c62c40bd5f\">nodule</span> compared to surrounding tissue.</li>\n<li>Increased risk of malignancy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Decreased uptake</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Cold Nodule-RAIU\" data-author=\"Kevin Banks\" data-hash=\"8187\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/cold-nodule-on-thyroid-scintigraphy\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/1u8XOgt6AH5EWhQaqun71744097586.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Grave's Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Also known as <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> toxic goiter</li>\n<li>Characterized by diffusely increased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> of iodine.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Diffuse increased uptake</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Grave's Disease-RAIU\" data-author=\"Arshdeep Sidhu\" data-hash=\"8188\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/graves-disease-thyroid-scintigraphy-3\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/G4xU2H1JTe0ov0JAu16s1744097788.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Toxic MNG</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Presence of both hot and cold nodules</li>\n<li>Hot nodules appear black and cold nodules appear white.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Mixed uptake</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Toxic MNG-RAIU\" data-author=\"Nathan McOrist\" data-hash=\"8189\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/toxic-multinodular-goitre-5\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/cgSQIDrnIcjC54k37B501744097817.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Thyroiditis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Inflammation and <span class=\"customMeta\" data-dictid=\"031a38f17a16927772036476ede2ae\">follicular</span> destruction leading to significantly decreased uptake.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>&lt; 5% uptake</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Thyroiditis-RAIU\" data-author=\"Nathan McOrist\" data-hash=\"8190\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/subacute-thyroiditis-5\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/FuszTwpeb1gs3o1jmLy21744097834.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 2-year-old boy presents with intermittent right lower quadrant pain and hematochezia. His parents report he has been irritable for the past few weeks. A scan is performed as given below. Which of the following is not a false positive for such type of scans?", "options": [{"label": "A", "text": "Chronâs disease", "correct": false}, {"label": "B", "text": "Appendicitis", "correct": false}, {"label": "C", "text": "Intussusception", "correct": false}, {"label": "D", "text": "Warthinâs tumor", "correct": true}], "correct_answer": "D. Warthinâs tumor", "question_images": ["https://image.prepladder.com/notes/1qGvrsCDjLq3lefgUo9r1744092794.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is incorrect about this scan?", "options": [{"label": "A", "text": "Fibrous cortical defects show hot spot", "correct": true}, {"label": "B", "text": "Tracer in the bladder is physiological", "correct": false}, {"label": "C", "text": "In cellulitis tracer does not show prolonged retention in delayed phase", "correct": false}, {"label": "D", "text": "Superscan is seen in hyperparathyroidism", "correct": false}], "correct_answer": "A. Fibrous cortical defects show hot spot", "question_images": ["https://image.prepladder.com/notes/9LOsuVQSw43NVHWFyxiq1744092337.png"], "explanation_images": ["https://image.prepladder.com/notes/nnaMzZ8gWIAHdgZsAZTv1744092351.png", "https://image.prepladder.com/notes/yJeCTFkj9xGVGeNaF8Cg1744092366.png", "https://image.prepladder.com/notes/hIOt6apkwK39PlQL1XVQ1744092386.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Nuclear medicine study using technetium-99m (<strong>Tc-99m-MDP</strong>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Absorption</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>~50% of <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> dose absorbed by bones (2-6 hours post-injection)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Phases of Study</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>1. Immediate phase</p>\n<p>2. Blood pool phase</p>\n<p>3. Delayed phase</p>\n<p>4. Optional delayed phase</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Detection and follow-up of skeletal metastases</li>\n<li>Radiographically <span class=\"customMeta\" data-dictid=\"c8d9b6cbbb1692777194c4bc31f01f\">occult</span> fractures (e.g., stress fractures)</li>\n<li>Osteomyelitis</li>\n<li>Complex regional pain syndrome</li>\n<li>Evaluation of <span class=\"customMeta\" data-dictid=\"c28d031bd31692777189aa73411316\">hip joint</span> <span class=\"customMeta\" data-dictid=\"17d0626681169277719604432b4d27\">prosthesis</span> for infection or loosening</li>\n<li>Paget disease</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Patient Preparation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Optimal hydration</li>\n<li>Remove metal objects</li>\n<li>Void before study</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Conditions Affecting Uptake</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> in kidneys/liver in conditions like <span class=\"customMeta\" data-dictid=\"baed0c93841692777200be26c8b9d2\">thalassemia</span> and hemochromatosis</li>\n<li>Poor image quality with <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> function</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Tracer Dose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>740 - 925 Mbq (20 - 25 mCi) administered intravenously in adults</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Renal Uptake</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Useful for detecting <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> abnormalities; faint/absent <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> commonly due to <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> insufficiency</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Results </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Normal</strong>: If the <span class=\"customMeta\" data-dictid=\"c5a32dfd6e1692777197db92b6aea1\">radiotracer</span> is present evenly throughout all the bones.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Abnormal: </strong></p>\n<ul>\n<li>Will show <strong>hot spots</strong> or<strong> cold spots</strong> as compared to surrounding bone.</li>\n<li><strong>Hot spots</strong> are areas where there is an increased collection of <span class=\"customMeta\" data-dictid=\"f391426a781692777197a16039bb5e\">radioactive</span> material.</li>\n<li><strong>Cold spots</strong> are areas that have taken up less of the <span class=\"customMeta\" data-dictid=\"f391426a781692777197a16039bb5e\">radioactive</span> material.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hot Spots</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Areas of<strong> new bone formation</strong>; are seen in:</p>\n<ul>\n<li>Fractures</li>\n<li>Osteomyelitis</li>\n<li>Osteoblastic bone metastasis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Cold Spots</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Seen in:</p>\n<ul>\n<li>Multiple <span class=\"customMeta\" data-dictid=\"aa6a0dfcb61692777193561ed10fac\">myeloma</span> (normal <span class=\"customMeta\" data-dictid=\"b95c7f7b821692777181df660ee7ff\">alkaline</span> phosphatase)</li>\n<li>Fibrous <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> defects (VS <span class=\"customMeta\" data-dictid=\"5d6dfa73b316927772028f3cd60f7f\">fibrous</span> <span class=\"customMeta\" data-dictid=\"984733db481692777186757cce6e6b\">dysplasia</span> shows hot spots)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Physiological Presence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li><strong>Tracer present in the bladder</strong> due to <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> <strong>(Option B)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Criteria</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Osteomyelitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Cellulitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Delayed Phase Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Tracer retained in the bone (hot spot)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>The <span class=\"customMeta\" data-dictid=\"887a04d130169277720091d7c1eeea\">tracer</span> <strong>does not</strong> show prolonged <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> in the bone <strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Blood Pool Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> can occur</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> can also occur</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1JpYnPSgNpBCnRpKWHAp1747761743.mp3", "video": ""}, {"text": "A 35-year-old female presents with fever, flank pain, and dysuria. A renal scan was performed as shown with the marked defect is given below. For this condition, what other pattern can be encountered on the scan?", "options": [{"label": "A", "text": "A single area of decreased cortical uptake", "correct": false}, {"label": "B", "text": "Multiple unilateral or bilateral defects", "correct": false}, {"label": "C", "text": "Diffuse involvement of an entire kidney", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": ["https://image.prepladder.com/notes/FM2i2PokT9jmPMCfcpvS1744091822.png"], "explanation_images": ["https://image.prepladder.com/notes/bOkYM9o7odIS4XW7cQYd1744091865.png", "https://image.prepladder.com/notes/d65MoSPtpzykddGfwuJT1744091899.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 6-year-old patient is referred for a renal scan to assess for potential scarring or morphological changes in the kidneys due to a history of recurrent urinary tract infections. Which of the following scans would be the most appropriate for evaluating the kidneys in this scenario?", "options": [{"label": "A", "text": "DTPA Scan", "correct": false}, {"label": "B", "text": "MAG3 Scan", "correct": false}, {"label": "C", "text": "DMSA Scan", "correct": true}, {"label": "D", "text": "Captopril DTPA Scan", "correct": false}], "correct_answer": "C. DMSA Scan", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:626px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Renal Scan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Purpose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Key Points</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>DMSA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Assess <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> or <span class=\"customMeta\" data-dictid=\"55beab619216927771925caac38373\">morphological</span> changes in kidneys (e.g., VUR)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Morphological/Static Scintigraphy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Identifies abnormalities (e.g., <span class=\"customMeta\" data-dictid=\"0decefe0901692777186f7f3f89b2a\">ectopic</span> kidney)</li>\n<li>IOC for VUR is VCUG/MCU</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>DTPA</strong> <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Assess <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> function (GFR)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Dynamic Scintigraphy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Estimates GFR</li>\n<li>Excreted by <span class=\"customMeta\" data-dictid=\"1ad1e71a4a1692777188853097f685\">glomerular</span> filtration, not <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> secretion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>MAG3 </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Evaluate overall <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> function</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Dynamic Scintigraphy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Assesses <span class=\"customMeta\" data-dictid=\"1c745475f51692777188c744487e6f\">GFR</span> and <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> function</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Diuretic Renography</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Assess <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> in pelvi-ureteric junction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Dynamic Scintigraphy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Rule in/out PUJ <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> in <span class=\"customMeta\" data-dictid=\"441df40d111692777189b0e31acb06\">hydronephrosis</span> without hydroureter</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Captopril DTPA</strong> <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Evaluate <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> <span class=\"customMeta\" data-dictid=\"0c9567c6cb16927771996c6bc2b21e\">stenosis</span> and other <span class=\"customMeta\" data-dictid=\"f56a973e95169277719749f66e748d\">renovascular</span> diseases.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Dynamic Scintigraphy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>A significant <span class=\"customMeta\" data-dictid=\"1c745475f51692777188c744487e6f\">GFR</span> decrease indicates <span class=\"customMeta\" data-dictid=\"15d91786931692777197c8932c8000\">RAAS</span> dependence</li>\n<li>Contraindicated in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> stenosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male presents to the emergency department with a 12-hour history of severe right upper quadrant pain. A scan is performed after the injection of a radiopharmaceutical as shown below. Which of the following findings is not consistent with the image shown?", "options": [{"label": "A", "text": "Cystic duct obstruction", "correct": true}, {"label": "B", "text": "Prompt excretion into the bile ducts", "correct": false}, {"label": "C", "text": "Tracer activity was seen in the gallbladder", "correct": false}, {"label": "D", "text": "Radioisotope used is 99mTc.", "correct": false}], "correct_answer": "A. Cystic duct obstruction", "question_images": ["https://image.prepladder.com/notes/nn4fKVhfh5PXaUYA3U1G1744091596.png"], "explanation_images": ["https://image.prepladder.com/notes/kIRD3F1yRluEsQgU4YWr1744091634.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:626px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>1. <span class=\"customMeta\" data-dictid=\"2b9b90ea9d16927771972379080f86\">Radiopharmaceutical</span> Injection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>A <span class=\"customMeta\" data-dictid=\"f391426a781692777197a16039bb5e\">radioactive</span> <span class=\"customMeta\" data-dictid=\"887a04d130169277720091d7c1eeea\">tracer</span> (e.g. iminodiacetic acid) is <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> through IV. This <span class=\"customMeta\" data-dictid=\"887a04d130169277720091d7c1eeea\">tracer</span> is taken up by the liver and <span class=\"customMeta\" data-dictid=\"7dd6eda7ce169277718325f22de9e8\">biliary</span> tract.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>2. <span class=\"customMeta\" data-dictid=\"49be0416121692777188dc8944b7bc\">Gamma</span> <span class=\"customMeta\" data-dictid=\"9c086ce80c1692777197e81a8c2d9f\">Ray</span> Detection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>As the <span class=\"customMeta\" data-dictid=\"887a04d130169277720091d7c1eeea\">tracer</span> moves from the liver to the <span class=\"customMeta\" data-dictid=\"1f51bf91811692777188d929c8e851\">gallbladder</span> and then to the duodenum, it emits <span class=\"customMeta\" data-dictid=\"49be0416121692777188dc8944b7bc\">gamma</span> rays, which are detected by a <span class=\"customMeta\" data-dictid=\"49be0416121692777188dc8944b7bc\">gamma</span> camera.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>3. Image Creation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>The <span class=\"customMeta\" data-dictid=\"49be0416121692777188dc8944b7bc\">gamma</span> camera is moved over the <span class=\"customMeta\" data-dictid=\"ac388c59831692777180f5a8e12913\">abdomen</span> to capture images, allowing <span class=\"customMeta\" data-dictid=\"33ba8d60fb16927772029d1067e602\">visualization</span> of the liver, gallbladder, and <span class=\"customMeta\" data-dictid=\"7dd6eda7ce169277718325f22de9e8\">biliary</span> tract, revealing their structure and function.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 32 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "What is the investigation of choice for the diagnosis of a parathyroid adenoma?", "options": [{"label": "A", "text": "Tc99-Sestamibi scan", "correct": true}, {"label": "B", "text": "Sestamibi SPECT", "correct": false}, {"label": "C", "text": "USG", "correct": false}, {"label": "D", "text": "CT", "correct": false}], "correct_answer": "A. Tc99-Sestamibi scan", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/uokLMNY8741zqychwGVe1745931167.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Investigation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Role in Diagnosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tc99-Sestamibi Scan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> in <span class=\"customMeta\" data-dictid=\"c3c9726266169277718021f4f0fa16\">adenoma</span> with delayed washout</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Gold standard for localization</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Sestamibi SPECT</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>3D <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> improves localization</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used when <span class=\"customMeta\" data-dictid=\"e485bb67f81692777191dfee6366cc\">localization</span> is unclear</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ultrasound (USG)</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypoechoic, well-defined <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> near thyroid</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>First-line for initial screening, but less sensitive than Sestamibi</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>CT (4D-CT preferred) (Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Enhances <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> detection</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used when other modalities fail</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Most common radio-isotope in pet scan :", "options": [{"label": "A", "text": "13C", "correct": false}, {"label": "B", "text": "14C", "correct": false}, {"label": "C", "text": "18F", "correct": true}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "C. 18F", "question_images": [], "explanation_images": [], "explanation": "<p>Correct answer C) 18F\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 12 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 32-year-old woman presents for a routine ultrasound at 28 weeks of gestation. The obstetrician notes an abnormal S/D ratio in the umbilical artery Doppler assessment. Which of the following implications is most likely associated with this finding?", "options": [{"label": "A", "text": "Low S/D ratio reflects increased resistance in placental blood flow", "correct": false}, {"label": "B", "text": "Increased resistance to blood flow in the placenta, indicating potential placental insufficiency", "correct": true}, {"label": "C", "text": "Fetal anemia requiring immediate intervention", "correct": false}, {"label": "D", "text": "Indicated fetal distress and warrants delivery", "correct": false}], "correct_answer": "B. Increased resistance to blood flow in the placenta, indicating potential placental insufficiency", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/LhJZrrxUUkVkY0Yv4rmS1744369361.png", "https://image.prepladder.com/notes/CGuTdwiTaC9HsrsU8dRP1744369361.png", "https://image.prepladder.com/notes/H98DvXLBzqx5ydgCNu2z1744369471.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AbpA8O3qcFtkzQSBvdkH1748239898.mp3", "video": ""}, {"text": "A 30-year-old female patient presents with infertility and undergoes radiological evaluation. Hysterosalpingography (HSG) reveals a \"tobacco pouch\" appearance and beaded fallopian tubes. Which of the following conditions is most likely responsible for these findings?", "options": [{"label": "A", "text": "Hydrosalpinx", "correct": false}, {"label": "B", "text": "Endometriosis", "correct": false}, {"label": "C", "text": "Female Genital Tuberculosis (FGTB)", "correct": true}, {"label": "D", "text": "Ovarian Cyst", "correct": false}], "correct_answer": "C. Female Genital Tuberculosis (FGTB)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/z9nweJLPSi5fTvFCpzNS1744412550.png", "https://image.prepladder.com/notes/L6jIlfcmLJCtOUjxmwfS1744412587.png", "https://image.prepladder.com/notes/OLowuvL5rfphgmdMxQBh1744412636.png", "https://image.prepladder.com/notes/S9I6Zx6wYiojosIcbhDC1744429537.png", "https://image.prepladder.com/notes/znrAv86OGBKoWbb8lYcS1744428010.png", "https://image.prepladder.com/notes/Ayd1G5ovkewS75nFGZrb1744428048.png", "https://image.prepladder.com/notes/VUoi5Q6ZH5YydtC65pab1744428117.png", "https://image.prepladder.com/notes/CX8epSH8o5gcaGzGwHaA1744428154.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rRr4K2Yj0uA8gXtRafHD1748418436.mp3", "video": ""}, {"text": "The following sign in breast MRI is characteristic of:", "options": [{"label": "A", "text": "Fibrocystic breast disease", "correct": false}, {"label": "B", "text": "Intracapsular breast implant rupture", "correct": true}, {"label": "C", "text": "Extracapsular breast implant rupture", "correct": false}, {"label": "D", "text": "Fat necrosis of the breast", "correct": false}], "correct_answer": "B. Intracapsular breast implant rupture", "question_images": ["https://image.prepladder.com/notes/SncktGJ5YzoTVtYhjoEp1746174367.png"], "explanation_images": ["https://image.prepladder.com/notes/N2cE46aI5B8ZpM0TZogX1744430108.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Lap9VOaPWGXrgOsFQTYv1746429268.mp3", "video": ""}, {"text": "A 17-year-old male presents to the emergency department with a sudden onset of severe left scrotal pain radiating to the groin. He describes nausea but denies any trauma. On examination, the left testis is high-riding, and there is tenderness upon palpation. Which imaging modality is preferred in this scenario?", "options": [{"label": "A", "text": "Computed Tomography", "correct": false}, {"label": "B", "text": "Magnetic Resonance Imaging", "correct": false}, {"label": "C", "text": "Ultrasonography", "correct": true}, {"label": "D", "text": "X-ray of the pelvis", "correct": false}], "correct_answer": "C. Ultrasonography", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ciincezu1jjpMLMrIRBT1748418570.mp3", "video": ""}, {"text": "Scrotal pain with the whirlpool sign on ultrasound is suggestive of:", "options": [{"label": "A", "text": "Torsion", "correct": true}, {"label": "B", "text": "Epididymo-orchitis", "correct": false}, {"label": "C", "text": "Varicocele", "correct": false}, {"label": "D", "text": "Hydrocele", "correct": false}], "correct_answer": "A. Torsion", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:447px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Finding</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Incomplete Torsion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Complete Torsion</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Whirlpool Sign</strong></p>\n<ul>\n<li>A most specific and sensitive sign</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Present</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Present</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Doppler </strong></p>\n<ul>\n<li>Blood flow is <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> or absent</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Reduced</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Absent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Elevated <span class=\"customMeta\" data-dictid=\"8459151fee1692777197d1ac765aa0\">Resistive</span> Index (RI)</strong></p>\n<ul>\n<li>RI &gt; 0.75 indicates compromised blood flow</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Elevated (RI &gt; 0.75)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Not applicable</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Size Increase</strong></p>\n<ul>\n<li>Enlargement of the <span class=\"customMeta\" data-dictid=\"4269f77ac216927772001f9b8edeb9\">testis</span> and epididymis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Not typically observed</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Present</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Echotexture Changes</strong></p>\n<ul>\n<li>Homogeneous: Early finding (before necrosis)</li>\n<li>Heterogeneous: Late finding (after 24 hours), suggests necrosis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Typically homogeneous</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Heterogeneous (after 24 hours)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Necrosis Indicators</strong></p>\n<ul>\n<li>Hypoechoic: represents necrosis.</li>\n<li>Hyperechoic Regions: represent haemorrhage (if reperfused).</li>\n</ul>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Not applicable</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Present</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PW8teiEM1PhnpipLAbKB1748418890.mp3", "video": ""}, {"text": "A 35-year-old woman presents to the clinic with a palpable lump in her right breast that she first noticed two weeks ago. The lump is round, mobile, and non-tender on examination. An ultrasound image is given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Simple cyst", "correct": true}, {"label": "B", "text": "Complex cyst", "correct": false}, {"label": "C", "text": "Complicated cyst", "correct": false}, {"label": "D", "text": "Breast cancer", "correct": false}], "correct_answer": "A. Simple cyst", "question_images": ["https://image.prepladder.com/notes/fNvO8nk0wRIKeer0ufTQ1747282870.png"], "explanation_images": ["https://image.prepladder.com/notes/DnV1pv6eH8fjuylCAOGr1747282930.png", "https://image.prepladder.com/notes/Oa8GpNyJEdbLJ4GlyFRQ1744429074.png", "https://image.prepladder.com/notes/JEf1i2MLmOJyxVbiiSox1744429117.png", "https://image.prepladder.com/notes/nVQ7zbB8NxDFRVQnk5SU1744429302.png", "https://image.prepladder.com/notes/8RxpymbGRyxXFLVlZOfu1744429354.png", "https://image.prepladder.com/notes/SjQEdvuOhmLeWH1GxlDZ1744429391.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:70%\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Breast pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>USG-findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>USG</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Simple <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Anechoic with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> enhancement</li>\n<li>Round or <span class=\"customMeta\" data-dictid=\"879f3da46a169277719497d18b5251\">ovoid</span> with a smooth <span class=\"customMeta\" data-dictid=\"165957ab9c16927771899a331e37b0\">hyperechoic</span> wall</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"Simple cyst with labelling \" data-author=\"\" data-hash=\"12740\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"264\" src=\"https://image.prepladder.com/notes/DnV1pv6eH8fjuylCAOGr1747282930.png\" width=\"440\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complicated cyst</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Internal echoes</li>\n<li>Fat-fluid level</li>\n<li>Oil cyst,<strong> galactocoel</strong></li>\n<li>Internal contents move with change in the position of the breast</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA741\" data-author=\"\" data-hash=\"9788\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/Oa8GpNyJEdbLJ4GlyFRQ1744429074.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complex cyst</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hyperechoic thin septations</li>\n<li>BI-RADS 3:Probably benign, needs follow-up</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA742\" data-author=\"\" data-hash=\"9789\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/JEf1i2MLmOJyxVbiiSox1744429117.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Abscess</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Ill-defined or</strong> well-defined outline</li>\n<li>Maybe <span class=\"customMeta\" data-dictid=\"acb59b05f31692777181d2df5f618b\">anechoic</span> or low-level internal echoes and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> enhancement</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA743\" data-author=\"\" data-hash=\"9790\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/nVQ7zbB8NxDFRVQnk5SU1744429302.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>BI-RADS 4/5/6</strong></p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypoechoic mass with <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> wall (spiculated)</li>\n<li>Taller than wide orientation</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA748\" data-author=\"\" data-hash=\"9791\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/8RxpymbGRyxXFLVlZOfu1744429354.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intraductal papilloma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dilated duct</li>\n<li>Well defined nodule</li>\n<li>BI-RADS 4A/4B/4C: suspicious for malignancy, <span class=\"customMeta\" data-dictid=\"754ab07a2e1692777183ed178c883d\">biopsy</span> advised</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"RA749\" data-author=\"\" data-hash=\"9792\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/SjQEdvuOhmLeWH1GxlDZ1744429391.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 52-year-old woman undergoes routine mammography screening. The report indicates a 1.5 cm spiculated mass with irregular borders in the upper outer quadrant of the right breast. The radiologist assigns it a BIRADS 5 category. Which of the following best describes the implication of a BIRADS 5 category on mammography?", "options": [{"label": "A", "text": "Highly suggestive of malignancy, &amp;gt;95% chance", "correct": true}, {"label": "B", "text": "Probably benign, &amp;lt;2% chance of malignancy", "correct": false}, {"label": "C", "text": "Highly suggestive of malignancy, &amp;lt;95% chance", "correct": false}, {"label": "D", "text": "Benign finding, no follow-up required", "correct": false}], "correct_answer": "A. Highly suggestive of malignancy, &gt;95% chance", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/RPF5RMEUoH5xq9QDSh2q1744428639.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following: Disease Mammography features a. Fibroadenoma (i) Eggshell calcification b. Fat Necrosis (ii) Broken-needle appearance c. Duct ectasia (iii) Teacup calcification d. Fibrocystic disease (iv) Popcorn calcifications", "options": [{"label": "A", "text": "a-iv, b-i, c-ii, d-iii", "correct": true}, {"label": "B", "text": "a-ii, b-iii, c-iv, d-i", "correct": false}, {"label": "C", "text": "a-iii, b-ii, c-iv, d-i", "correct": false}, {"label": "D", "text": "a-iii, b-iv, c-i, d-ii", "correct": false}], "correct_answer": "A. a-iv, b-i, c-ii, d-iii", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/DyadXsAg3woyd3ItB8LQ1744398313.png", "https://image.prepladder.com/notes/3oZRYi3AVvLLztko2H1Y1744397980.png", "https://image.prepladder.com/notes/Ki7S6npIvniEVJHrDW3X1744398104.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:592px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mammographic Findings</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fibroadenoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Round, well-circumscribed mass with smooth borders; <strong>\"popcorn\" calcifications </strong>in older lesions. Benign.</p>\n<p><img alt=\"RA738\" data-author=\"\" data-hash=\"9686\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/DyadXsAg3woyd3ItB8LQ1744398313.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fat Necrosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Irregular, <span class=\"customMeta\" data-dictid=\"d9873d32e01692777199c6a1f6ecfc\">spiculated</span> mass with calcifications; central fat density - Eggshell calcification</strong>. Often mimics malignancy.</p>\n<p><img alt=\"RA736\" data-author=\"\" data-hash=\"9681\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/3oZRYi3AVvLLztko2H1Y1744397980.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ductal <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">Carcinoma</span> <span class=\"customMeta\" data-dictid=\"96aaaa68ce1692777190096abe3c8a\">in Situ</span> (DCIS)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microcalcifications <strong>(Segmental distribution of <span class=\"customMeta\" data-dictid=\"d391ed597c1692777195574de6cc11\">pleomorphic</span> microcalcifications)</strong>, often <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">linear</span> or branching, are associated with malignancy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Invasive Ductal Carcinoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irregular, <span class=\"customMeta\" data-dictid=\"d9873d32e01692777199c6a1f6ecfc\">spiculated</span> mass with poorly defined margins. Microcalcifications and architectural distortion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fibrocystic disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Teacup calcification</strong> represents the layering out of <span class=\"customMeta\" data-dictid=\"3d9d9f347c1692777183a60d99394a\">calcific</span> material in the dependent portion of microcysts on a <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"279228dffd1692777191c834a27177\">magnification</span> view.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duct ectasia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Broken-needle appearance</strong>, typical of <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> ectasia. Sometimes thicker, more <span class=\"customMeta\" data-dictid=\"8fb8df140b1692777191702bbc9358\">localized</span> calcifications can be seen, giving a<strong> âlead-pipeâ appearance.</strong></p>\n<p><img alt=\"RA737\" data-author=\"\" data-hash=\"9684\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/Ki7S6npIvniEVJHrDW3X1744398104.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gCfcWooRb8iGnklgAC0p1745339944.mp3", "video": ""}, {"text": "A 28-year-old woman is evaluated for a pelvic mass. An ultrasound shows a complex ovarian mass with a Rokitansky nodule and areas of calcification. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Endometrioma", "correct": false}, {"label": "B", "text": "Serous cystadenoma", "correct": false}, {"label": "C", "text": "Ovarian dermoid", "correct": true}, {"label": "D", "text": "Ovarian carcinoma", "correct": false}], "correct_answer": "C. Ovarian dermoid", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:594px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ultrasound (US)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cystic mass with an <span class=\"customMeta\" data-dictid=\"91b98150ea169277718629280d911c\">echogenic</span> nodule<strong> (Rokitansky nodule) </strong>projecting into the lumen.<br/>\n\t\t\tPredominantly <span class=\"customMeta\" data-dictid=\"91b98150ea169277718629280d911c\">echogenic</span> mass with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> sound <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> <strong>(tip of the iceberg sign)</strong> due to <span class=\"customMeta\" data-dictid=\"359edf0778169277719886070af9db\">sebaceous</span> material and hair.<br/>\n\t\t\tCystic mass with <strong>fine internal <span class=\"customMeta\" data-dictid=\"91b98150ea169277718629280d911c\">echogenic</span> lines (Dot and dash appearance)</strong> representing hair.<br/>\n\t\t\tFluid-fluid level representing <span class=\"customMeta\" data-dictid=\"359edf0778169277719886070af9db\">sebaceous</span> material floating on fluid.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Computed <span class=\"customMeta\" data-dictid=\"8d4f2a375b1692777200f41db641bc\">Tomography</span> (CT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Presence of <strong>fat and calcifications (e.g., teeth, bones).</strong><br/>\n\t\t\t </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Magnetic <span class=\"customMeta\" data-dictid=\"37b9856df8169277719716b550a15f\">Resonance</span> <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> (MRI)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sensitive to fat</strong> Fat-fluid and fluid-fluid levels, low signal intensity calcifications (e.g., teeth).<br/>\n<strong>Rokitansky nodule/dermoid <span class=\"customMeta\" data-dictid=\"7803d1e7ea169277719552dc5e49d4\">plug</span> attached to the <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> wall.</strong><br/>\n\t\t\t </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YwXhFbPpbiZ6xrDjM2w71748419351.mp3", "video": ""}, {"text": "A 35-year-old woman presents with heavy menstrual bleeding and pelvic pressure. An ultrasound reveals a well-circumscribed, hypoechoic, solid uterine mass with shadowing. What is the most likely imaging diagnosis?", "options": [{"label": "A", "text": "Endometrial carcinoma", "correct": false}, {"label": "B", "text": "Uterine fibroid (leiomyoma)", "correct": true}, {"label": "C", "text": "Ovarian cyst", "correct": false}, {"label": "D", "text": "Adenomyosis", "correct": false}], "correct_answer": "B. Uterine fibroid (leiomyoma)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/pOuiB5gqBEvgZCHU6UAR1744396914.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 42-year-old woman presents with chronic pelvic pain, dysmenorrhea, and menorrhagia. Transvaginal ultrasound shows an enlarged, asymmetrical uterus with sub-endometrial linear striations, 3-mm cysts, and a \"rain shower\" appearance. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Uterine fibroids", "correct": false}, {"label": "B", "text": "Endometrial polyp", "correct": false}, {"label": "C", "text": "Adenomyosis", "correct": true}, {"label": "D", "text": "Endometriosis", "correct": false}], "correct_answer": "C. Adenomyosis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/IvHnjg6BRV97557vQBGw1744396269.png", "https://image.prepladder.com/notes/AyJcDBVbT5DUD0CvsIr21744396467.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:627px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging Modality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Findings in Adenomyosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ultrasound (TVUS)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Enlarged, <span class=\"customMeta\" data-dictid=\"7fb01b5ad51692777188c3cb1733f9\">globular</span> <span class=\"customMeta\" data-dictid=\"0c847ca20416927772011b3397c2fd\">uterus</span> with <span class=\"customMeta\" data-dictid=\"0bead1317716927771827dc3e80706\">asymmetry</span> of the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> walls</li>\n<li>Diffuse <span class=\"customMeta\" data-dictid=\"91b98150ea169277718629280d911c\">echogenic</span> nodules</li>\n<li>Subendometrial <span class=\"customMeta\" data-dictid=\"91b98150ea169277718629280d911c\">echogenic</span> <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">linear</span> striations <strong>(Venetian blind sign)</strong></li>\n<li>Subendometrial cysts (2-6 mm), seen in 50% of cases</li>\n<li>Endometrial pseudo widening</li>\n<li><strong>Poor definition of the endo-myometrial interface</strong></li>\n<li>Multiple fine areas of <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> <strong>(ârain showerâ appearance)</strong></li>\n<li><strong>A speckled pattern</strong> of increased <span class=\"customMeta\" data-dictid=\"05493772261692777201c10c4ee537\">vascularity</span> on <strong>Color Doppler</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI (T2-weighted images)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ill-defined areas of low myometrial signal intensity due to smooth muscle hyperplasia<br/>\n<strong>Diffuse or <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> thickening of the junctional zone (JZ)</strong></p>\n<ul>\n<li>JZ âĽ12 mm strongly predicts adenomyosis;</li>\n<li>JZ â¤8 mm excludes it</li>\n</ul>\n<p><br/>\n\t\t\tHigh T2 signal intensity <span class=\"customMeta\" data-dictid=\"e2071f8f891692777203982b3fa0f5\">foci</span> within low signal <span class=\"customMeta\" data-dictid=\"46cc90d0e216927771936d8239e379\">myometrium</span> (ectopic endometrial tissue or <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> dilatation)<strong> (Salt and Pepper appearance)</strong></p>\n<p>High T2 signal <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">linear</span> striations <strong>(finger-like projections)</strong> extending from the <span class=\"customMeta\" data-dictid=\"2f1603da6716927771878d0cbdd372\">endometrium</span> into myometrium</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MRI (T1-weighted images)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High T1 signal intensity <span class=\"customMeta\" data-dictid=\"e2071f8f891692777203982b3fa0f5\">foci</span> represent small <span class=\"customMeta\" data-dictid=\"77074d46b51692777196747de93965\">punctate</span> haemorrhages, with a 95% <span class=\"customMeta\" data-dictid=\"6ec8c6811e1692777196da36a72ad6\">positive predictive value</span> for adenomyosis</p>\n</td>\n</tr>\n</tbody>\n\n<p><strong>References:</strong></p>\n<ul><li>âł Grainger and Allison Diagnostic Radiology, Ed.7, page 901, 902</li><li>âł Feeding artery sign (endometrial polyp) | Radiology Reference Article | Radiopaedia.org</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old woman with a history of infertility is undergoing evaluation. The scan image is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Septate uterus", "correct": true}, {"label": "B", "text": "Arcuate uterus", "correct": false}, {"label": "C", "text": "Bicornuate uterus", "correct": false}, {"label": "D", "text": "Unicornuate uterus", "correct": false}], "correct_answer": "A. Septate uterus", "question_images": ["https://image.prepladder.com/notes/4bwpjx4ru9k40gKrxmQH1744365251.png"], "explanation_images": ["https://image.prepladder.com/notes/wwEiTmicv8EzgfheSff11744365253.png", "https://image.prepladder.com/notes/US5MeWD1GXtB1c4uNKcW1744365255.png", "https://image.prepladder.com/notes/4jJpIWHRdjvAJqovv9vY1744365254.png", "https://image.prepladder.com/notes/dmuplqWcsfUoQLwhgJZV1744365258.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gPOkGUCouSGvaqhOPXay1748158103.mp3", "video": ""}, {"text": "A 30-year-old woman undergoing controlled ovarian hyperstimulation for in vitro fertilization presents with abdominal pain and significant distension. Which of the following is the most likely finding on an ultrasound seen in this patient that helps differentiate it from PCOS?", "options": [{"label": "A", "text": "Echogenic stroma", "correct": false}, {"label": "B", "text": "Ovarian volume &amp;gt;10 ml", "correct": false}, {"label": "C", "text": "Presence of ascites", "correct": true}, {"label": "D", "text": "Multiple cysts measuring 2-9 mm", "correct": false}], "correct_answer": "C. Presence of ascites", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/UPugsAmomJCheLrI9Gom1744369841.png", "https://image.prepladder.com/notes/n7OGu9ZrZv9E0yIupMUv1744369841.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/BS6eYsQR8x86WTZ8Pwjr1748240138.mp3", "video": ""}, {"text": "Which of the following is not typically associated with IUFD as observed on ultrasound?", "options": [{"label": "A", "text": "Maceration", "correct": false}, {"label": "B", "text": "Spalding sign", "correct": false}, {"label": "C", "text": "Increased amniotic fluid volume", "correct": true}, {"label": "D", "text": "Presence of soft tissue edema", "correct": false}], "correct_answer": "C. Increased amniotic fluid volume", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/5gtF5g9Ah5Kbz3MH5H5M1744368608.png", "https://image.prepladder.com/notes/wH6KwYaHBxJLU9Z7b5tg1744368608.png", "https://image.prepladder.com/notes/CIukvcjvjQ27kMYuIEKS1744368609.png", "https://image.prepladder.com/notes/hRZvOUE4uRaTp4FWDEJb1744368727.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Step</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Initial Assessment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Conduct <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> to confirm absence of <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> <span class=\"customMeta\" data-dictid=\"bf4c28aebb1692777188074f2facbb\">heartbeat</span> and other signs of demise.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2. Follow-Up Imaging</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Use <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> for further evaluation if <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> is inconclusive or more details are needed.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/nBJXzXBZwGzk8QB7dzf91748239641.mp3", "video": ""}, {"text": "A 12-week pregnant patient presents with a nuchal translucency (NT) measurement of 3.2 mm during her first-trimester ultrasound. What is the most appropriate follow-up ultrasound examination to assess for potential anomalies?", "options": [{"label": "A", "text": "Second-trimester anatomy scan at 20 weeks", "correct": true}, {"label": "B", "text": "Fetal echocardiography", "correct": false}, {"label": "C", "text": "Nuchal translucency re-evaluation at 16 weeks", "correct": false}, {"label": "D", "text": "Doppler ultrasound of the umbilical artery", "correct": false}], "correct_answer": "A. Second-trimester anatomy scan at 20 weeks", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/xir0yuj36dcI6u7XWHGg1744367995.png", "https://image.prepladder.com/notes/sShxLIQDWQgA2adLDIzb1744367996.png", "https://image.prepladder.com/notes/Nwjn8Y2rUFAxS9D2wWvP1744368227.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PFqTmzy6ps5OgSuL4dEv1748239464.mp3", "video": ""}, {"text": "An ultrasound scan image of a 30-year-old woman who presented for a routine ultrasound at 6 weeks of gestation is shown below. What is the most significant ultrasound finding in this case?", "options": [{"label": "A", "text": "T-sign", "correct": false}, {"label": "B", "text": "Lambda sign", "correct": true}, {"label": "C", "text": "Snowstorm appearance", "correct": false}, {"label": "D", "text": "Pseudogestational sac", "correct": false}], "correct_answer": "B. Lambda sign", "question_images": ["https://image.prepladder.com/notes/B03QpLW6AjJ5QDQgCM7x1744367734.png"], "explanation_images": ["https://image.prepladder.com/notes/awFL56RwosiKyRFASJO01744367995.png", "https://image.prepladder.com/notes/AC7prIFxEjQo3YgQ8jgW1744446661.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:376px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Placentaâs <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> status</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Timing of cleavage</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DiamnioticâDichorionic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&lt; 72 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DiamnioticâMonochorionic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Days 4â7</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MonoamnioticâMonochorionic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Days 8â12</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conjoined</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Day &gt;13</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/j27D2VOinV4g6HW95rqJ1748239100.mp3", "video": ""}, {"text": "A 33-year-old woman with a history of tubal ligation presents with sudden lower abdominal pain and vaginal bleeding. She has a positive serum hCG, and transvaginal ultrasound is shown below. What is the most definitive radiological feature confirming the diagnosis of ectopic pregnancy in this case?", "options": [{"label": "A", "text": "Ring of fire appearance", "correct": true}, {"label": "B", "text": "Lambda sign", "correct": false}, {"label": "C", "text": "Trilaminar appearance", "correct": false}, {"label": "D", "text": "Double decidual sac sign", "correct": false}], "correct_answer": "A. Ring of fire appearance", "question_images": ["https://image.prepladder.com/notes/KOBrOG8KFOfHjDVGyHtq1744367733.png"], "explanation_images": ["https://image.prepladder.com/notes/xu5aPMHsUuCT2hvwXgEj1744367733.png", "https://image.prepladder.com/notes/KOBrOG8KFOfHjDVGyHtq1744367733.png", "https://image.prepladder.com/notes/oK40z8k3cSKGZMZfeebC1744367734.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3YFixHmTRCxemBZR6weN1748238888.mp3", "video": ""}, {"text": "A 30-year-old woman with a history of recurrent pregnancy loss presents to the Obstetrics clinic at 4.5 weeks gestation for her ultrasound scanning appointment. An image of the transvaginal ultrasound is shown below. shows a well-defined gestational sac with the double decidual sac sign, but no yolk sac or fetal pole is visible. What is the significance of this ultrasound finding?", "options": [{"label": "A", "text": "High likelihood of ectopic pregnancy", "correct": false}, {"label": "B", "text": "Accurate measurement of gestational age", "correct": false}, {"label": "C", "text": "Indicative of an intrauterine pregnancy", "correct": true}, {"label": "D", "text": "Suspicious for a molar pregnancy", "correct": false}], "correct_answer": "C. Indicative of an intrauterine pregnancy", "question_images": ["https://image.prepladder.com/notes/rBkYXQkZJwD3PKSR88Vw1744367372.png"], "explanation_images": ["https://image.prepladder.com/notes/qXfix6bsMYuJfRvGOEHU1744367373.png", "https://image.prepladder.com/notes/PQhrNhbEMcP9000RK7dp1744367373.png", "https://image.prepladder.com/notes/HXMaDHdGi9ufED9Ax7n51744367373.png", "https://image.prepladder.com/notes/gRYhgLAiCdcpXUKF16WV1744446660.png", "https://image.prepladder.com/notes/zqIWMlcZ0pLDmoN6d7wh1744367374.png", "https://image.prepladder.com/notes/XFipADxzxGrSUSSiPzha1744367375.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Structures visualized </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gestational age (TVS)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gestational sac</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4.5 to 5 weeks</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First sign of pregnancy in an ultrasound</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Yolk sac</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5 to 6 weeks</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First <span class=\"customMeta\" data-dictid=\"32b854324a1692777185c6c79fdc99\">definitive</span> sign of an <span class=\"customMeta\" data-dictid=\"1d5d2712dc169277719050154d38a1\">intrauterine</span> pregnancy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fetal heartbeat</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5.5 to 6 weeks</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>M-mode is preferred for the assessment of <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> activity.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/eplyVAnC8hJTKj7jeKGO1748238650.mp3", "video": ""}, {"text": "A 32-year-old woman with a history of infertility and recurrent pelvic discomfort is undergoing further evaluation with imaging. She has no history of recent infections but had an episode of acute pelvic inflammatory disease (PID) 5 years ago that was treated with antibiotics. The radiological image is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Hydrosalpinx", "correct": true}, {"label": "B", "text": "Ovarian cyst", "correct": false}, {"label": "C", "text": "Uterine adhesions", "correct": false}, {"label": "D", "text": "Right Cornual obstruction", "correct": false}], "correct_answer": "A. Hydrosalpinx", "question_images": ["https://image.prepladder.com/notes/ZDoNJaurOelXM5uEGYd21744366721.png"], "explanation_images": ["https://image.prepladder.com/notes/ZDoNJaurOelXM5uEGYd21744366721.png", "https://image.prepladder.com/notes/AsGjJ6O62noZYhO5H5SE1744366722.png", "https://image.prepladder.com/notes/1EUJGOmClTIhTeYqVODm1744366724.png", "https://image.prepladder.com/notes/JpOZl5w5K6zEXYGJqyuh1744366725.png", "https://image.prepladder.com/notes/qD5TAcGMT2W1AV0SPBU81744366726.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Mp0h3Ej90mgqI8apy52F1748158753.mp3", "video": ""}, {"text": "A 34-year-old woman is undergoing a fertility evaluation. The transvaginal USG image is shown below. Which phase of the menstrual cycle is she most likely in?", "options": [{"label": "A", "text": "Menstrual phase", "correct": false}, {"label": "B", "text": "Early proliferative phase", "correct": false}, {"label": "C", "text": "Late proliferative phase", "correct": true}, {"label": "D", "text": "Secretory phase", "correct": false}], "correct_answer": "C. Late proliferative phase", "question_images": ["https://image.prepladder.com/notes/XnMs3ZXxTrRMJuoGgCC11744365525.png"], "explanation_images": ["https://image.prepladder.com/notes/1DR8cvKHBtGGzLLgf5tX1744365523.png", "https://image.prepladder.com/notes/XnMs3ZXxTrRMJuoGgCC11744365525.png", "https://image.prepladder.com/notes/fPuPVKkJqWcDZEU7bTmM1744365526.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YgTzByOf52djqH6SkViE1748158284.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 30 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following methods is used to measure fetal anemia?", "options": [{"label": "A", "text": "Umbilical artery Doppler", "correct": false}, {"label": "B", "text": "Cord blood sampling", "correct": false}, {"label": "C", "text": "Chorionic villus sampling", "correct": false}, {"label": "D", "text": "Peak systolic velocity in the fetal middle cerebral artery (MCA)", "correct": true}], "correct_answer": "D. Peak systolic velocity in the fetal middle cerebral artery (MCA)", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Method</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Utility</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Invasiveness</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MCA-PSV <span class=\"customMeta\" data-dictid=\"eb476e70a316927771861ad68beaae\">Doppler</span> (Correct Answer)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gold standard for <strong>non-invasive</strong> <span class=\"customMeta\" data-dictid=\"723fdec66b1692777186e92f0c6fdf\">detection</span> of <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> anemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-invasive</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Umbilical <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> Doppler</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Assesses <strong>placental insufficiency</strong> (not <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> anemia)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-invasive</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cord blood <span class=\"customMeta\" data-dictid=\"521de62abe16927771989a90d0e9e8\">sampling</span> (PUBS - <span class=\"customMeta\" data-dictid=\"b2fb1a3a5416927771953ea4fa15e1\">Percutaneous</span> <span class=\"customMeta\" data-dictid=\"9cc3973459169277720194a0847477\">Umbilical</span> Blood Sampling)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Directly measures <strong>fetal <span class=\"customMeta\" data-dictid=\"ad2073fe6716927771885f3c1ec652\">hemoglobin</span> and hematocrit</strong> but has high risk of complications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Invasive</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chorionic <span class=\"customMeta\" data-dictid=\"b0bb7d5b6716927772028625a93e1e\">villus</span> <span class=\"customMeta\" data-dictid=\"521de62abe16927771989a90d0e9e8\">sampling</span> (CVS)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used for <strong>genetic testing</strong> in the first trimester, not <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> anemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Invasive</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is most likely to show the following finding on USG?", "options": [{"label": "A", "text": "Fibroadenoma", "correct": true}, {"label": "B", "text": "Breast cyst", "correct": false}, {"label": "C", "text": "Breast carcinoma", "correct": false}, {"label": "D", "text": "Metastasis to the breast from another primary site", "correct": false}], "correct_answer": "A. Fibroadenoma", "question_images": ["https://image.prepladder.com/notes/NVA6D6mPcD3UgeD876Fl1747656627.png"], "explanation_images": ["https://image.prepladder.com/content/HlWYdn8DdYYp9B0LAlua1747373120.png", "https://image.prepladder.com/content/dGuVkbJSJtFyIPAm6X1o1747373120.png", "https://image.prepladder.com/content/hyvxJ8MvNgiLJYWtcCFa1747373120.png", "https://image.prepladder.com/content/kjlX48hhCVspyzMlHgzw1747373120.png", "https://image.prepladder.com/content/QfOophWIcrEUJoC9QCvr1747373120.png", "https://image.prepladder.com/content/XIS7d86s8chirGPDz0UR1747373120.png", "https://image.prepladder.com/content/KLGMiP4mHYxbTnpC6Irq1747373121.png", "https://image.prepladder.com/content/U5QXjqjqtNWLlsj4B5zo1747373121.png", "https://image.prepladder.com/content/y9nvTzpBR9JORCV5L2xU1747373121.png", "https://image.prepladder.com/content/jebEPdogNSHC03f1DaDn1747373121.png", "https://image.prepladder.com/notes/canAy7LQnNDKRXc6J8fQ1747656768.png", "https://image.prepladder.com/content/7g61Bhn6uUB8gYmYRtNK1747373121.png", "https://image.prepladder.com/content/ZBCKxmJjYp0BHTC78R4v1747373121.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:1000px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Breast pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>USG-findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>USG</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Simple cyst</strong></p>\n<p><strong>(Option B) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Anechoic with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> enhancement</li>\n<li>Round or <span class=\"customMeta\" data-dictid=\"879f3da46a169277719497d18b5251\">ovoid</span> with a smooth <span class=\"customMeta\" data-dictid=\"165957ab9c16927771899a331e37b0\">hyperechoic</span> wall</li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author='\"Nirupama Anne Elisabeth Sulger Ratnakishore Pallapothu\"' data-hash=\"\" data-license=\"CC BY-NC 4.0\" data-source=\"https://www.researchgate.net/figure/Right-breast-ultrasound-demonstrates-an-irregular-shaped-hypoechoic-solid-mass-located_fig1_333903796\" data-tags=\"\" height=\"232\" src=\"https://image.prepladder.com/content/HlWYdn8DdYYp9B0LAlua1747373120.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Complicated cyst</strong></p>\n<p> </p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Internal echoes</li>\n<li>Fat-fluid level</li>\n<li>Oil cyst,<strong> galactocoel</strong></li>\n<li>Internal contents move with change in the position of the breast</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Daniel J Bell\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/galactocele-1\" data-tags=\"\" height=\"218\" src=\"https://image.prepladder.com/content/dGuVkbJSJtFyIPAm6X1o1747373120.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Complex cyst</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hyperechoic thin septations</li>\n<li>BI-RADS 3:Probably benign, needs follow-up</li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Serdar ĂzbaĹM. ErkuĹC. KaramanA. Menderes\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/COMPLEX-BREAST-CYSTS%3A-SONOGRAPHIC-FINDINGS-AND-%C3%96zba%C5%9F-Erku%C5%9F/1cd7adec50abe4d4fbed67532568aa6fefa744a8\" data-tags=\"\" height=\"203\" src=\"https://image.prepladder.com/content/hyvxJ8MvNgiLJYWtcCFa1747373120.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Abscess</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Ill-defined or</strong> well-defined outline</li>\n<li>Maybe <span class=\"customMeta\" data-dictid=\"acb59b05f31692777181d2df5f618b\">anechoic</span> or low-level internal echoes and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> enhancement</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author='\"Alphonce B Chandika Antony Gakwaya Elsie Kiguli-Malwadde Phillipo Chalya\"' data-hash=\"\" data-license=\"CC BY 2.0\" data-source=\"https://www.researchgate.net/figure/A-sonogram-of-a-22-yrs-old-female-showing-a-right-breast-abscess-Note-the-oval-shape-of_fig1_221730043\" data-tags=\"\" height=\"184\" src=\"https://image.prepladder.com/content/kjlX48hhCVspyzMlHgzw1747373120.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fibrocystic disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Prominent fibro <span class=\"customMeta\" data-dictid=\"c2f9d01ba91692777188d264244b6a\">glandular</span> tissue in the area of a <span class=\"customMeta\" data-dictid=\"bd478e4ff816927771949528846af9\">palpable</span> nodule; however, no discernible mass</li>\n<li>small cysts in the mammary zone</li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Park, Chang &amp; Lee, Jae &amp; Yim, Hyeon &amp; Kang, Bong &amp; Kim, hyeon sook &amp; Jung, Jung Im &amp; Jung, Na Young &amp; Kim, Sung. \" data-hash=\"\" data-license=\"CC BY-NC 3.0\" data-source=\"https://www.researchgate.net/figure/US-in-a-47-year-old-woman-with-fibrocystic-disease-The-mass-shows-six-or-seven_fig3_5920832\" data-tags=\"\" height=\"208\" src=\"https://image.prepladder.com/content/QfOophWIcrEUJoC9QCvr1747373120.png\" width=\"270\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fibroadenoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Round/ovoid <span class=\"customMeta\" data-dictid=\"5543384a9b169277718985e08cf7f8\">hypoechoic</span> mass</li>\n<li>May have a <span class=\"customMeta\" data-dictid=\"165957ab9c16927771899a331e37b0\">hyperechoic</span> rim (pseudo capsule)</li>\n<li>Parallel orientation(wider than tall)</li>\n<li>May have calcifications</li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Sandeep Singh Awal\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/fibroadenoma-of-the-breast-2\" data-tags=\"\" height=\"178\" src=\"https://image.prepladder.com/content/XIS7d86s8chirGPDz0UR1747373120.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cystosarcoma phyllodes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Inhomogeneous, solid-appearing mass is the (most common)</li>\n<li>A solid mass containing single or multiple, round or cleft-like <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> spaces and demonstrating <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> enhancement</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Lee, Eun &amp; Chang, Yun-Woo &amp; Oh, Jung &amp; Hwang, Jiyoung &amp; Hong, Seong &amp; Kim, Hyun-joo. (2018). Breast Lesions in Children and Adolescents: Diagnosis and Management. Korean Journal of Radiology. 19. 978. 10.3348/kjr.2018.19.5.978. \" data-hash=\"\" data-license=\"CC BY-NC 4.0\" data-source=\"https://www.researchgate.net/figure/Phyllodes-tumor-in-17-year-old-girl-with-palpable-mass-in-left-breast-Ultrasonographic_fig5_326894580\" data-tags=\"\" height=\"184\" src=\"https://image.prepladder.com/content/KLGMiP4mHYxbTnpC6Irq1747373121.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fat necrosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Acute\n\t\t\t\t<ul>\n<li>New lesion</li>\n<li>Hyperechoic due to edema</li>\n<li>BI-RADS 3</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Late\n\t\t\t\t<ul>\n<li>1.5 years or more</li>\n<li>Calcified walls causing a <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> shadow</li>\n<li>BI-RADS 3</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Natacha AbreuM. GoncalvesM. SerradoA. F. Capelinha\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Fat-necrosis-of-the-breast%3A-is-it-%28at%29-all-Abreu-Goncalves/6ec31c7b8fe4f683971eb5b868c13fb4df9d73ae/figure/1\" data-tags=\"\" height=\"210\" src=\"https://image.prepladder.com/content/U5QXjqjqtNWLlsj4B5zo1747373121.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>BI-RADS 4/5/6</strong></p>\n<p><strong>(Option C,D)</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypoechoic mass with <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> wall (spiculated)</li>\n<li>Taller than wide orientation</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Madani, Mohammad &amp; Behzadi, Mohammad &amp; Nabavi, Sheida. (2022). The Role of Deep Learning in Advancing Breast Cancer Detection Using Different Imaging Modalities: A Systematic Review. Cancers. 14. 5334. 10.3390/cancers14215334. \" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Ultrasound-images-from-breast-tissue-for-normal-benign-and-malignant-80_fig2_364975652\" data-tags=\"\" height=\"217\" src=\"https://image.prepladder.com/content/y9nvTzpBR9JORCV5L2xU1747373121.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Intraductal papilloma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Dilated duct</li>\n<li>Well defined nodule</li>\n<li>BI-RADS 4A/4B/4C: suspicious for malignancy, <span class=\"customMeta\" data-dictid=\"754ab07a2e1692777183ed178c883d\">biopsy</span> advised</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\" Alexandra Stanislavskyâ\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/cases/intraductal-papilloma-4\" data-tags=\"\" height=\"195\" src=\"https://image.prepladder.com/content/jebEPdogNSHC03f1DaDn1747373121.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Duct ectasia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Dilated ducts with branching <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> <span class=\"customMeta\" data-dictid=\"acb59b05f31692777181d2df5f618b\">anechoic</span> structures</li>\n<li>Diametre &gt;2 mm</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"Duct ectasia\" data-author=\"Anand, Gaurav &amp; Calisi, Nabil &amp; Arif, Dauod &amp; Hamidpour, Soheila &amp; Lewis, Tiffany. \" data-hash=\"12990\" data-license=\"CC BY-NC ND\" data-source=\"https://www.researchgate.net/figure/A-Ultrasound-image-showing-moderate-to-marked-duct-ectasia-in-the-retroareolar-region_fig2_324129091\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/canAy7LQnNDKRXc6J8fQ1747656768.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Implant rupture</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Step ladder sign: <span class=\"customMeta\" data-dictid=\"d02067c4b51692777191b8eec8b062\">linear</span> <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> <span class=\"customMeta\" data-dictid=\"165957ab9c16927771899a331e37b0\">hyperechoic</span> bands representing folds in collapsed shell</li>\n<li>Suggests <span class=\"customMeta\" data-dictid=\"9c6f97404e1692777190f9ed62079f\">intracapsular</span> rupture</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author='\"Jocelyn Rapelyea Christina G. Marks\"' data-hash=\"\" data-license=\"CC BY 3.0\" data-source='https://www.researchgate.net/figure/Stepladder-sign-Transverse-ultrasound-demonstrates-an-intracapsular-silicone-implant_fig4_322562378\t\"Jocelyn Rapelyea Christina G. Marks\"' data-tags=\"\" height=\"215\" src=\"https://image.prepladder.com/content/7g61Bhn6uUB8gYmYRtNK1747373121.png\" width=\"248\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Silicone granuloma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Snowstorm sign: <span class=\"customMeta\" data-dictid=\"165957ab9c16927771899a331e37b0\">Hyperechoic</span> and well-circumscribed <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> border with dirty <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> shadow</li>\n<li>Suggests <span class=\"customMeta\" data-dictid=\"ab0f3917ce1692777187309ec78709\">extracapsular</span> rupture</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Š Nevit Dilmen\" data-hash=\"\" data-license=\"CC BY-SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Silicone_granuloma#/media/File:Ultrasound_of_silicone_granuloma_lymphadenopathy_13112514493060900.jpg\" data-tags=\"\" height=\"288\" src=\"https://image.prepladder.com/content/ZBCKxmJjYp0BHTC78R4v1747373121.png\" width=\"249\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Banana sign on USG is seen in which of the following conditions?", "options": [{"label": "A", "text": "Omphalocele", "correct": false}, {"label": "B", "text": "Spina bifida", "correct": true}, {"label": "C", "text": "Anencephaly", "correct": false}, {"label": "D", "text": "Encephalocele", "correct": false}], "correct_answer": "B. Spina bifida", "question_images": ["https://image.prepladder.com/content/nkPKna3zDUMgwpjhIuXB1745998856.png"], "explanation_images": ["https://image.prepladder.com/content/6AvOcCw9iH1qpUdM1hop1745998890.png", "https://image.prepladder.com/content/SR7HAOpmvbhBMMpYpV7I1745998890.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:500px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Spina Bifida</strong> <strong>(Myelomeningocele)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"a9c41a58d816927771847775d63d96\">cerebellum</span> appears flattened and curled at the base, creating a \"banana\" shape due to tethering of the <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> cord.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Dave, K.D., &amp; Solanki, S.M.\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Spectrum-of-Cranio-facial-anomalies-during-2-nd-on-Dave-Solanki/66f6f18c60b84a9c0f0581fa5b8ec8b42cf929fb/figure/6\" data-tags=\"\" height=\"349\" src=\"https://image.prepladder.com/content/6AvOcCw9iH1qpUdM1hop1745998890.png\" width=\"417\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<p><strong>A lemon sign</strong> indicates a flattened <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> bone often seen in <span class=\"customMeta\" data-dictid=\"78d32c50611692777199c6c6b9b525\">spina</span> bifida.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Dave, K.D., &amp; Solanki, S.M.\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Spectrum-of-Cranio-facial-anomalies-during-2-nd-on-Dave-Solanki/66f6f18c60b84a9c0f0581fa5b8ec8b42cf929fb/figure/5\" data-tags=\"\" height=\"432\" src=\"https://image.prepladder.com/content/SR7HAOpmvbhBMMpYpV7I1745998890.png\" width=\"455\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Omphalocele</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Abdominal organs protrude through the <span class=\"customMeta\" data-dictid=\"9cc3973459169277720194a0847477\">umbilical</span> cord, covered by a membrane.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Anencephaly</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>The brain and skull fail to develop fully, leading to severe <span class=\"customMeta\" data-dictid=\"b00388be25169277719369b3ab059f\">neural</span> tube defects.</p>\n<p>Absence of the <strong>brain</strong>, with partial or total lack of the <strong>skull.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Encephalocele</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Brain tissue protrudes through a skull defect, forming a sac-like structure.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not a benefit of ultrasound (USG) compared to mammography?", "options": [{"label": "A", "text": "USG can be used to detect calcifications, asymmetries, and distortions better than mammography", "correct": true}, {"label": "B", "text": "Can be used for guided biopsy", "correct": false}, {"label": "C", "text": "In young females with dense breasts", "correct": false}, {"label": "D", "text": "Can be used to differentiate solid VS cystic", "correct": false}], "correct_answer": "A. USG can be used to detect calcifications, asymmetries, and distortions better than mammography", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:499px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Ultrasound (USG)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Mammography</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Microcalcifications detection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Poor</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Excellent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Architectural distortion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Poor</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Good</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Best for dense breasts</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Yes (young females)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Limited sensitivity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Solid vs. <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> differentiation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Excellent</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Poor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Guided biopsy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Yes (stereotactic)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Radiation exposure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>None</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Yes (low dose)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the diagnosis based on the given image?", "options": [{"label": "A", "text": "Uterus didelphys", "correct": false}, {"label": "B", "text": "Bicornuate uterus", "correct": false}, {"label": "C", "text": "Unicornuate uterus", "correct": true}, {"label": "D", "text": "Septate uterus", "correct": false}], "correct_answer": "C. Unicornuate uterus", "question_images": ["https://image.prepladder.com/content/5RFfvZ4oldhFCHSBlxUk1691499188.png"], "explanation_images": ["https://image.prepladder.com/content/74h6CMabpSncObTNKgk71695368496.png", "https://image.prepladder.com/content/Yp2J2ZcEtvHhyiQMo1QQ1695368469.png", "https://image.prepladder.com/content/mM6KjVvz7ak7crNygLef1695368463.png", "https://image.prepladder.com/content/VsrzcUqSKogodqWQOT6s1695368476.png", "https://image.prepladder.com/content/BhXG3eETyIaAfetp7bjE1695368481.png"], "explanation": "<p>Correct Option C: Unicornuate uteru\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The image seen below shows", "options": [{"label": "A", "text": "Magnetic Resonance Imaging", "correct": false}, {"label": "B", "text": "Positron Emission Tomogrpahy", "correct": false}, {"label": "C", "text": "Hysterosalpingography", "correct": true}, {"label": "D", "text": "Laparoscopic chromopertubation", "correct": false}], "correct_answer": "C. Hysterosalpingography", "question_images": ["https://image.prepladder.com/content/NUcnPqI5NdP6akWmW4cT1691499261.png"], "explanation_images": ["https://image.prepladder.com/content/hImrvfYQdBl83MIgH98r1695368585.png"], "explanation": "<p>Correct Option C: Hysterosalpingograph\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 16 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient presents with a neck mass and laboratory findings of increased T4 and decreased TSH. The patient has a history of I-131 ablation therapy. Which of the following is a likely side effect of the treatment?", "options": [{"label": "A", "text": "Acute Thyroiditis", "correct": false}, {"label": "B", "text": "Hypothyroidism", "correct": false}, {"label": "C", "text": "Hyperthyroidism", "correct": true}, {"label": "D", "text": "Thyroid Storm", "correct": false}], "correct_answer": "C. Hyperthyroidism", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common in</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hypothyroidism (Correct Answer)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Destruction of <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> tissue â <strong>â T4, â TSH</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most patients post-I-131 therapy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute Thyroiditis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Radiation-induced <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> â temporary <strong>thyroid pain, swelling</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Early post-treatment phase</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hyperthyroidism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thyrotoxic phase</strong> due to sudden hormone release from damaged cells</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare, transient</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thyroid Storm</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Massive release of <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> hormones <strong>(life-threatening)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Very rare, usually in untreated Graves'</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Radioisotope used in PET-CT scan?", "options": [{"label": "A", "text": "18F-FDG", "correct": true}, {"label": "B", "text": "lodine", "correct": false}, {"label": "C", "text": "Radium", "correct": false}, {"label": "D", "text": "Cesium-131", "correct": false}], "correct_answer": "A. 18F-FDG", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/w81knXENAoUUijn4J4mu1747313278.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Aerobic Glycolysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cancer cells rely heavily on glycolysis, increasing <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> and 18F-FDG uptake, even with oxygen.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Transport &amp; Trapping</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>GLUT-1 transporters mediate <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> entry. 18F-FDG is phosphorylated and trapped inside cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tumor Heterogeneity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Differences in tumor subtype, size, and <span class=\"customMeta\" data-dictid=\"3728deb0881692777192af3b093774\">microvasculature</span> affect 18F-FDG uptake.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Implication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Prognostic Indicator</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Higher 18F-FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> correlates with <strong>worse prognosis</strong> (e.g., shorter DFS in <span class=\"customMeta\" data-dictid=\"1c5272ad3d1692777190e71409d07a\">invasive</span> ductal carcinoma).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Reverse Warburg Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cancer-associated fibroblasts (CAFs) increase <span class=\"customMeta\" data-dictid=\"185a500ee91692777188b3044db06d\">glycolysis</span> in tumor cells via <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> coupling.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment Monitoring</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>PET <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> tracks changes in 18F-FDG uptake, reflecting <strong>therapy responses</strong> <span class=\"customMeta\" data-dictid=\"e4865847fa169277720044d7b530b0\">targeting</span> <span class=\"customMeta\" data-dictid=\"185a500ee91692777188b3044db06d\">glycolysis</span> or mitochondria.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Radioactive isotope used for teletherapy?", "options": [{"label": "A", "text": "Iridium-192", "correct": false}, {"label": "B", "text": "lodine-125", "correct": false}, {"label": "C", "text": "Cobalt-60", "correct": true}, {"label": "D", "text": "lodine-131", "correct": false}], "correct_answer": "C. Cobalt-60", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:589px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Types of Beams</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Electrons</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Negatively charged particles</li>\n<li>Limited penetration</li>\n<li>Effective for tumors near the body surface (Skin tumors)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Photons </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Can reach deep tumors</li>\n<li>Scatter radiation along the path</li>\n<li>Continue through normal tissue after reaching the tumor</li>\n<li>Made up of high energy:\n\t\t\t\t<ul>\n<li>X-rays (LINAC- Linear accelerators)</li>\n<li>Gamma rays</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Protons</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Positively charged particles</li>\n<li>No radiation scatter</li>\n<li>Stop precisely at the tumor location</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>cobalt 60 (Co<sub>60</sub>)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Linear accelerator</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"e3555f448716927771844820d69cfa\">Cobalt</span> machine produces an artificial <span class=\"customMeta\" data-dictid=\"4dd949a23a1692777197a5627fa8d8\">radioisotope</span> (Co )</li>\n<li>Advantage: Relative <span class=\"customMeta\" data-dictid=\"a4d5e86b6416927771850468afd1ba\">constancy</span> of beam output</li>\n<li>Source replacement approximately every 4 to 5 years</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>LINAC- Linear accelerators do not need a radioisotope</li>\n<li>The fast-moving <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> beam generates radiation which is used in radiotherapy</li>\n<li>X-ray beams are produced</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the name of the radiotherapy treatment given to a cancer patient that involves administering a dose of 1.8 to 2 Gy once daily for 5 days per week over a period of 6 to 8 weeks?", "options": [{"label": "A", "text": "Regular Fractionated radiotherapy", "correct": true}, {"label": "B", "text": "Hyper fractionated radiotherapy", "correct": false}, {"label": "C", "text": "Accelerated fractionation radiotherapy", "correct": false}, {"label": "D", "text": "Brachytherapy", "correct": false}], "correct_answer": "A. Regular Fractionated radiotherapy", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/wV44ebMhXTomUlYh8Kbi1746437048.png", "https://image.prepladder.com/content/g1k7BnuL9wyaNtF7nyrV1746437048.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Technique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Spatially Fractionated Radiation Therapy (SFRT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Delivers <span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">heterogeneous</span> doses to spare normal tissue, effective in bulky tumors.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hyperfractionation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>More frequent, smaller doses to enhance local control.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Accelerated Fractionation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Shortens overall treatment time, maintaining or enhancing efficacy.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Side effects of Pituitary irradiation?", "options": [{"label": "A", "text": "Hypopituitarism", "correct": false}, {"label": "B", "text": "Increased risk of cerebrovascular accident", "correct": false}, {"label": "C", "text": "Optic nerve damage", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which phase of the cell cycle displays the highest resistance to radiation among the following options?", "options": [{"label": "A", "text": "S phase", "correct": true}, {"label": "B", "text": "M phase", "correct": false}, {"label": "C", "text": "G1 phase", "correct": false}, {"label": "D", "text": "G2 phase", "correct": false}], "correct_answer": "A. S phase", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A child with acute lymphoblastic leukemia undergoes prophylactic irradiation prior autologous hematopoietic stem cell transplantation. Which of the following will be the least affected?", "options": [{"label": "A", "text": "Spermatogonia", "correct": false}, {"label": "B", "text": "Intestinal epithelial cells", "correct": false}, {"label": "C", "text": "Neurons", "correct": true}, {"label": "D", "text": "Bone marrow/ erythroid precursor cells", "correct": false}], "correct_answer": "C. Neurons", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/P7mJJWUGf5HAkupbBxzT1746445894.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following radioactive isotopes is not employed in brachytherapy?", "options": [{"label": "A", "text": "Iodine-125", "correct": false}, {"label": "B", "text": "Iodine-131", "correct": true}, {"label": "C", "text": "Cobalt-60", "correct": false}, {"label": "D", "text": "Iridium-192", "correct": false}], "correct_answer": "B. Iodine-131", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/kJv7cZT8ti96VYe9NbB41684993170.png"], "explanation": "<p>Correct Option B\n<table style=\"width:100%\">\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Isotope</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Half -Life</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Decay Process</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Photon Energy (KeV)</strong></p>\n</td>\n</tr>\n<tr>\n<td><sup>226</sup>Ra</td>\n<td>1.600 y</td>\n<td>Îą</td>\n<td>830</td>\n</tr>\n<tr>\n<td><sup>60</sup>Co</td>\n<td>5.26</td>\n<td>β</td>\n<td>1.250</td>\n</tr>\n<tr>\n<td><sup>125</sup>I</td>\n<td>59.4 d</td>\n<td>e-capture</td>\n<td>35</td>\n</tr>\n<tr>\n<td><sup>109</sup>Pd</td>\n<td>17 d</td>\n<td>e-capture</td>\n<td>21</td>\n</tr>\n<tr>\n<td><sup>131</sup>Cs</td>\n<td>9.7 d</td>\n<td>e-capture</td>\n<td>30</td>\n</tr>\n<tr>\n<td><sup>137</sup>Cs</td>\n<td>30 t</td>\n<td>β</td>\n<td>662</td>\n</tr>\n<tr>\n<td><sup>192</sup>Ir</td>\n<td>74.3d</td>\n<td>β</td>\n<td>380</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which situation is the Bragg peak effect most prominent?", "options": [{"label": "A", "text": "Xray", "correct": false}, {"label": "B", "text": "Proton", "correct": true}, {"label": "C", "text": "Neutron", "correct": false}, {"label": "D", "text": "Electron", "correct": false}], "correct_answer": "B. Proton", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/j3izBH9gXEEV4HF6HRLb1695368550.png", "https://image.prepladder.com/content/FPSHw96rROwEziEpU10J1695368543.png"], "explanation": "<p>Correct Option B: P\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 19 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A woman with endometrial carcinoma is undergoing radiotherapy. Which of the following is true?", "options": [{"label": "A", "text": "Intensity is inversely proportional to the square of the distance from the source", "correct": true}, {"label": "B", "text": "Small blood vessels are most radioresistant", "correct": false}, {"label": "C", "text": "Rapidly proliferating cells are most radioresistant", "correct": false}, {"label": "D", "text": "Small intestinal mucosa is most radio-resistant", "correct": false}], "correct_answer": "A. Intensity is inversely proportional to the square of the distance from the source", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the cause of the double bleb sign observed during early pregnancy?", "options": [{"label": "A", "text": "Twin pregnancy", "correct": false}, {"label": "B", "text": "Amnion and chorion", "correct": false}, {"label": "C", "text": "Yolk sac and amniotic sac", "correct": true}, {"label": "D", "text": "Heterotopic pregnancy", "correct": false}], "correct_answer": "C. Yolk sac and amniotic sac", "question_images": ["https://image.prepladder.com/notes/FSbbmFvH1YjHow5ymWgP1747112484.png"], "explanation_images": ["https://image.prepladder.com/notes/jnYttv0CiRF2mGKCnHr41746439094.png", "https://image.prepladder.com/notes/62h870s36hC2JOxv9qH11746439354.png", "https://image.prepladder.com/notes/kskAYWxgmFz2hpdsuinf1746439401.png", "https://image.prepladder.com/notes/kncZf8ezcFucZVOwfKxP1746439446.png", "https://image.prepladder.com/notes/G7gfRcbxHE34mETUemGD1746439489.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Structures visualized </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gestational age (TVS)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gestational sac</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4.5 to 5 weeks</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First sign of pregnancy in an ultrasound</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Yolk sac</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5 to 6 weeks</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First reliable sign of an <span class=\"customMeta\" data-dictid=\"1d5d2712dc169277719050154d38a1\">intrauterine</span> pregnancy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fetal heartbeat</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5.5 to 6 weeks</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>M-mode is preferred for the assessment of <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> activity.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 12 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
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Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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A chest radiograph was taken which revealed the condition as shown in the image below. What is the likely cause of hypertension in this patient?", "options": [{"label": "A", "text": "Coarctation of aorta", "correct": true}, {"label": "B", "text": "Essential hypertension", "correct": false}, {"label": "C", "text": "Aortic aneurysm", "correct": false}, {"label": "D", "text": "Aorta-arteritis", "correct": false}], "correct_answer": "A. Coarctation of aorta", "question_images": ["https://image.prepladder.com/content/JJPwh63KmX39WlUAeTl01746516442.png"], "explanation_images": ["https://image.prepladder.com/content/ceMGJWNNWmmo6l2HIJbN1746516518.png", "https://image.prepladder.com/content/GEQZAJCVxH24xxCcsHsj1746516518.png"], "explanation": "\n<p><strong>References:</strong></p>\n<ul><li>âł Coarctation of the aorta | Radiology Reference Article | Radiopaedia.org</li><li>âł Grainger and Allisonâs Textbook of Diagnostic Radiology, 7th edition, Page 300</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A child presents with cyanosis. His chest radiograph is shown below. What is the diagnosis?", "options": [{"label": "A", "text": "Tetralogy of Fallot (TOF)", "correct": true}, {"label": "B", "text": "Ebsteinâs anomaly", "correct": false}, {"label": "C", "text": "Transposition of great arteries (TGA)", "correct": false}, {"label": "D", "text": "Total anomalous pulmonary venous return (TAPVC)", "correct": false}], "correct_answer": "A. Tetralogy of Fallot (TOF)", "question_images": ["https://image.prepladder.com/notes/7IAG9TTQVWaPPb2QSrh71745246832.jpg"], "explanation_images": ["https://image.prepladder.com/notes/z0p41c8Ioz783RYEpfmf1745246131.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the heart chamber marked in the given CT image", "options": [{"label": "A", "text": "Right atrium", "correct": false}, {"label": "B", "text": "Right ventricle", "correct": false}, {"label": "C", "text": "Left ventricle", "correct": false}, {"label": "D", "text": "Left atrium", "correct": true}], "correct_answer": "D. Left atrium", "question_images": ["https://image.prepladder.com/notes/wBNSw7YKc1Mse7hQQOjY1747914532.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Chamber</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Location on CT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Right Atrium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anterior, right side</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Receives deoxygenated blood from IVC/SVC</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Right Ventricle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Most <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lies close to the sternum, pumps blood to <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> artery</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Left Atrium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Posterior aspect</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Receives oxygenated blood from <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> veins</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Left Ventricle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Left, inferior</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Thickest-walled chamber, pumps blood into aorta</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In what situation is popcorn calcification observed?", "options": [{"label": "A", "text": "Hodgkinâs lymphoma", "correct": false}, {"label": "B", "text": "Pulmonary hamartoma", "correct": true}, {"label": "C", "text": "Metastasis", "correct": false}, {"label": "D", "text": "Fungal ball", "correct": false}], "correct_answer": "B. Pulmonary hamartoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/xGSPsQ7gYn79QO6IA98A1745921354.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Obliteration of the right cardiac border on chest X-ray indicated pathology involving which of the following structures? [", "options": [{"label": "A", "text": "Right lower lobe", "correct": false}, {"label": "B", "text": "Right Atrium", "correct": false}, {"label": "C", "text": "Right middle lobe", "correct": true}, {"label": "D", "text": "Right ventricle", "correct": false}], "correct_answer": "C. Right middle lobe", "question_images": ["https://image.prepladder.com/content/ivpLRRQ1HRUHXJTHifak1747909870.png"], "explanation_images": ["https://image.prepladder.com/content/PZ39Pc2Uq4FVWAP6mudU1746091606.png", "https://image.prepladder.com/content/RmadEwdvGDXK130n36gt1747909882.png", "https://image.prepladder.com/content/NSfdtxKi5kJNhizQYkQM1747909893.png", "https://image.prepladder.com/content/lvYBQDxZqmVcRofThvPG1747909927.png", "https://image.prepladder.com/content/oH7MbNIs21n9ug6wICAo1747909941.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:453px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Obliterated <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">Cardiac</span> Border</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Likely Affected Lobe</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Right <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> border</strong> (Right atrium)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Right Middle Lobe</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Right hemidiaphragm</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Right Lower Lobe</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Left <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> border</strong> (Left ventricle)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lingula (Left Upper Lobe)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Left hemidiaphragm</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Left Lower Lobe</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Comment on the diagnosis of CT chest shown below.", "options": [{"label": "A", "text": "Aortic dissection", "correct": true}, {"label": "B", "text": "Pulmonary embolism", "correct": false}, {"label": "C", "text": "Cardiac myxoma", "correct": false}, {"label": "D", "text": "Aortic aneurysm", "correct": false}], "correct_answer": "A. Aortic dissection", "question_images": ["https://image.prepladder.com/content/T2g1oiqmxxOcmORb1wYA1747910070.png"], "explanation_images": ["https://image.prepladder.com/content/ECnNOl2vtoTACpqfcPDl1746092976.png", "https://image.prepladder.com/content/E03c1F9KafB4FopQDgmV1747910085.png", "https://image.prepladder.com/content/ZY3aezFfpS45MYEzHMF31748163825.png", "https://image.prepladder.com/content/tqQkbJJqMskBbrHE0OxE1748163840.png", "https://image.prepladder.com/content/Ds2tqJcnYKAokJyOJ5p71747910205.png", "https://image.prepladder.com/content/VVATh3MaTWhePONAIzgT1747910212.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55 year old male patient presented with complaints of dyspnea with congestive heart failure. The clinician wants to know whether it's HF with preserved EF or reduced EF. Which of the below investigation is used for calculation of ejection fraction?", "options": [{"label": "A", "text": "MUGA", "correct": true}, {"label": "B", "text": "SPECT using thallium", "correct": false}, {"label": "C", "text": "PET myocardial perfusion imaging", "correct": false}, {"label": "D", "text": "Sestamibi scan with pharmacological stress", "correct": false}], "correct_answer": "A. MUGA", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/h2RwDGIc7m882BAGN5zA1747910599.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:618px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Purpose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Scan types</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>For Myocardial <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">Perfusion</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Assess ischemia</li>\n<li><strong>Cold spot: </strong>decreased <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> in ischemic areas.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Thallium scan (Commonly used) <strong>(Option B)</strong></li>\n<li>Tetrofosmin</li>\n<li>Sestamibi scan <strong>(Option D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>For Myocardial Infarction </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Assess infarct</li>\n<li><strong>Hot spot</strong> in <span class=\"customMeta\" data-dictid=\"7d8fbc62391692777190399f2b0126\">infarct</span> area as <span class=\"customMeta\" data-dictid=\"53da8f40b5169277719620504e0cb9\">pyrophosphate</span> accumulates and is not metabolized.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>99m Tc - <span class=\"customMeta\" data-dictid=\"53da8f40b5169277719620504e0cb9\">Pyrophosphate</span> scan.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>For <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">Ventricular</span> Function </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Evaluate <span class=\"customMeta\" data-dictid=\"3b69bda4d21692777187109c85a27e\">ejection</span> fraction</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>MUGA</strong> (Multiple Gated Acquisition) scan (AKA nuclear ventriculography)\n\t\t\t\t<ul>\n<li>Radiolabeled RBCs are used</li>\n</ul>\n</li>\n<li>Most accurate for <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> function - <strong>Cardiac MRI</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>For Myocardial <span class=\"customMeta\" data-dictid=\"a8dece102f16927772026b199f06af\">Viability</span> </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Assess the <span class=\"customMeta\" data-dictid=\"a8dece102f16927772026b199f06af\">viability</span> of myocardium</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>PETscan </strong>- Best investigation for myocardial viability. <strong>(Option C)</strong>\n<ul>\n<li><strong>Perfusion</strong> and<strong> <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> mismatch</strong> are observed in the PET scan.</li>\n<li><strong>Perfusion Agents</strong>:N-13 <span class=\"customMeta\" data-dictid=\"edbc0adbb31692777181ed0ee792d4\">ammonia</span> and Rubidium chloride.</li>\n<li><strong>Metabolism Agent</strong>: FDG-PET is used for <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> metabolism.\n\t\t\t\t\t<ul>\n<li>No FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> indicates a <strong>normal heart</strong> or an<strong> infarct.</strong></li>\n<li>FDG <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> is present: In the <strong>Ischemic Myocardium</strong></li>\n</ul>\n</li>\n<li>FDG-PET is combined with <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> for comprehensive assessment.\n\t\t\t\t\t<ul>\n<li>Uptake in PET with low <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> indicates <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> (suggestive of <strong>hibernation</strong>).</li>\n<li>Irreversible <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> indicates the presence of <strong>scar tissue</strong>.</li>\n</ul>\n</li>\n<li><strong>Note:</strong> Hibernating <span class=\"customMeta\" data-dictid=\"c64e23ddb8169277719344010b3fc0\">myocardium</span> is ischemic but viable.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is accurate concerning CORADS? CORADS: COVID-19 Reporting and Data System", "options": [{"label": "A", "text": "CORADS- 0 indicates normal lung", "correct": false}, {"label": "B", "text": "CORADS-5 is typical of COVID- 19", "correct": true}, {"label": "C", "text": "Pleural thickening is typical of COVID-19", "correct": false}, {"label": "D", "text": "Lobar consolidation is typical of COVID-19", "correct": false}], "correct_answer": "B. CORADS-5 is typical of COVID- 19", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Purpose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Categorical assessment of chest CT scans for suspected <span class=\"customMeta\" data-dictid=\"2d364aeaf7169277718529fa58f6ea\">COVID-19</span> cases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Scale</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>CO-RADS 1 (very low suspicion) to CO-RADS 5 (very high suspicion)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Interobserver Agreement</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Moderate to substantial agreement among radiologists</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Discriminatory Power</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>High accuracy in diagnosing COVID-19</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Utility &amp; Reliability</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Effective and standardized reporting tool</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>CO-RADS-AI</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>AI-based tool that automates CO-RADS scoring and CT severity assessment</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Accuracy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Effective in high-prevalence areas</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Combination with Other Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>AUC value of <strong>0.89</strong> when used with RT-PCR and clinical findings</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old male patient with Marfanoid features presented with a sudden onset of breathlessness. The chest X-ray is given below. What is the diagnosis?", "options": [{"label": "A", "text": "Pneumothorax", "correct": true}, {"label": "B", "text": "Pleural effusion", "correct": false}, {"label": "C", "text": "Consolidation", "correct": false}, {"label": "D", "text": "Fibrosis", "correct": false}], "correct_answer": "A. Pneumothorax", "question_images": ["https://image.prepladder.com/content/iVssf1KeqFVDtQU0Wp8h1745842035.png"], "explanation_images": ["https://image.prepladder.com/content/1g7Ym4K1H3kfIvVInieV1745842098.png", "https://image.prepladder.com/content/frpkiJx66YD595NhokHX1745842110.png", "https://image.prepladder.com/content/oru044ajq44zl5sOHW9E1745842123.png", "https://image.prepladder.com/content/pIZsdYOK3SfwV23nQa1y1745842135.png", "https://image.prepladder.com/content/2hBvSnXgmyoqGJv6Twk81745842148.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Primary</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No underlying lung disease, seen in tall, thin males (e.g., Marfan syndrome)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Secondary</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Occurs in patients with underlying lung disease (e.g., COPD, tuberculosis)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tension Pneumothorax</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Air trapping leads to <strong>mediastinal shift</strong>, requiring emergency intervention</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Radiological findings in <span class=\"customMeta\" data-dictid=\"d9d1e6f2801692777196f37b28fb6a\">pneumothorax</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Visible visceral pleural</strong> <strong>edge </strong>as a thin white line.</li>\n<li><strong>Absent lung markings </strong>peripheral to this line.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Karthik Easvur\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:X-ray_of_pneumothorax_signs.jpg\" data-tags=\"\" height=\"254\" src=\"https://image.prepladder.com/content/1g7Ym4K1H3kfIvVInieV1745842098.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The affected side is <strong>radiolucent </strong>compared to the opposite side.</li>\n<li><strong>Collapsed lung </strong>on the affected side.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Karthik Easvur\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:X-ray_of_pneumothorax_signs.jpg\" data-tags=\"\" height=\"254\" src=\"https://image.prepladder.com/content/frpkiJx66YD595NhokHX1745842110.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contralateral <span class=\"customMeta\" data-dictid=\"1014e4cf5e169277719246e0ca91df\">mediastinal</span> </strong>shift especially in massive pneumothoraces (tension pneumothorax).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Karthik Easvur\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:X-ray_of_pneumothorax_signs.jpg\" data-tags=\"\" height=\"254\" src=\"https://image.prepladder.com/content/oru044ajq44zl5sOHW9E1745842123.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"5b42867b61169277718692205c2447\">diaphragm</span> of the affected side is pushed down.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Karthik Easvur\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:X-ray_of_pneumothorax_signs.jpg\" data-tags=\"\" height=\"254\" src=\"https://image.prepladder.com/content/pIZsdYOK3SfwV23nQa1y1745842135.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The<strong> supine</strong> <span class=\"customMeta\" data-dictid=\"5c71603ac81692777197e2aa1e7fd3\">radiograph</span> shows the<strong> deep <span class=\"customMeta\" data-dictid=\"2a56f52a921692777199df43853eba\">sulcus</span> sign.</strong></li>\n<li>It shows a <strong>deep <span class=\"customMeta\" data-dictid=\"03b5b4a6ef1692777185c8ff0d80d2\">costophrenic</span> angle</strong> extending towards the hypochondrium.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Braegel\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Pneumothorax_im_liegen.jpg\" data-tags=\"\" height=\"260\" src=\"https://image.prepladder.com/content/2hBvSnXgmyoqGJv6Twk81745842148.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Plethoric lung fields are seen in?", "options": [{"label": "A", "text": "TAPVC", "correct": true}, {"label": "B", "text": "Tricuspid atresia", "correct": false}, {"label": "C", "text": "Ebstein anomaly", "correct": false}, {"label": "D", "text": "TOF", "correct": false}], "correct_answer": "A. TAPVC", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Cp8YLyhl6w85GizrJcTV1745237975.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Total Anomalous <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">Venous</span> Connection (TAPVC)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pulmonary veins drain into the right <span class=\"customMeta\" data-dictid=\"a8d33da8541692777182ec6983d9a2\">atrium</span> directly or indirectly via an <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> connection</li>\n<li>Not a ductal-dependent cyanotic lesion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sites of <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> connection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Supracardiac- superior <span class=\"customMeta\" data-dictid=\"3ddf6d5ea71692777201b70c8b9715\">vena</span> <span class=\"customMeta\" data-dictid=\"67544ba6ef16927771835d4641cc8f\">cava</span> (Most common)</li>\n<li>Cardiac-coronary sinus, right atrium</li>\n<li>Infracardiac</li>\n<li>Mixed</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cyanosis and congestive <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> failure</li>\n<li>With ASD- wide and split S2</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chest X-ray</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Snowman or figure-8 <span class=\"customMeta\" data-dictid=\"1792af7b92169277718423182d599d\">configuration</span> in supracardiac TAPVC</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Sara P. MagalhĂŁes, Nuno Moreno, MarĂlia Loureiro, Manuela França, Fernanda Reis, Silvia Alvares, Manuel Ribeiro\" data-hash=\"\" data-license=\"CC BY-NC ND\" data-source=\"https://www.researchgate.net/figure/A-Chest-X-ray-showing-cardiomegaly-and-moderate-pulmonary-venous-congestion-B_fig3_311655923\" data-tags=\"\" height=\"541\" src=\"https://image.prepladder.com/content/Cp8YLyhl6w85GizrJcTV1745237975.png\" width=\"486\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Surgery</li>\n<li>No indication for prostaglandins (Not a ductal-dependent cyanotic lesion)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with a history of breast cancer underwent Cobalt-60 radiotherapy. She now presents with respiratory distress, and imaging shows haziness in the left lung. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Radiation Pneumonitis", "correct": true}, {"label": "B", "text": "Recurrence of Breast Cancer", "correct": false}, {"label": "C", "text": "Pulmonary Embolism", "correct": false}, {"label": "D", "text": "Infective Pneumonia", "correct": false}], "correct_answer": "A. Radiation Pneumonitis", "question_images": ["https://image.prepladder.com/content/NibuZI2xe1tLqfV4nvUr1741087739.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Radiation damage to lung tissue, commonly from <strong>breast, lung, or <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> cancer radiotherapy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Onset</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4-12 weeks</strong> post-radiotherapy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dry cough, dyspnea, <span class=\"customMeta\" data-dictid=\"5297b5833216927771910b7a85de53\">low-grade</span> fever, chest pain</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hazy opacities in the <strong>irradiated lung field</strong> (CT: <span class=\"customMeta\" data-dictid=\"c70bf4cd73169277718868a5f3904b\">ground-glass</span> opacities, consolidation)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Corticosteroids (prednisone), supportive care</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The appearance of USG at saphenofemoral junction, showing common femoral vein, common femoral artery, and the great saphenous vein is called as:", "options": [{"label": "A", "text": "Mickey Mouse sign", "correct": true}, {"label": "B", "text": "String sign", "correct": false}, {"label": "C", "text": "Tillaux sign", "correct": false}, {"label": "D", "text": "Stamers sign", "correct": false}], "correct_answer": "A. Mickey Mouse sign", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/zNON9xL05HhMa7A1SzJR1746516677.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Radiological Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Associated Pathology</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Classic Mickey Mouse Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Refers to the appearance of <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve (CN) VII and CN VIII enhancement, resembling Mickey Mouse's head.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Acoustic neuroma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Reverse Mickey Mouse Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>The reverse of the classic Mickey Mouse sign, where <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> CN V and CN VI <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> resemble Mickey Mouse's head.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Trigeminal schwannoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Minnie Mouse Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Refers to <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> CN VII and CN VIII enhancement, resembling Minnie Mouse's head.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Facial nerve <span class=\"customMeta\" data-dictid=\"491e5b2e851692777198ba329e42ce\">schwannoma</span> or hemangioma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Mickey Mouse Ears Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Describes <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"86c230abe316927771889bbef8df5d\">globus</span> pallidus hyperintensity on brain MRI, resembling the shape of Mickey Mouse's ears.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Wilsonâs disease or Carbon <span class=\"customMeta\" data-dictid=\"03077f6c8716927771923763487a9e\">monoxide</span> poisoning</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Mickey Mouse Glove Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Characterized by symmetric <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">calcification</span> of <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> <span class=\"customMeta\" data-dictid=\"f2804c808516927771887dda93e56c\">ganglia</span> structures on brain CT, resembling a Mickey Mouse glove.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Fahrâs syndrome or Wilsonâs disease</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a 36-year-old farmer who presented with a cough, chest pain lasting one week, fatigue persisting for a month, and a chest x-ray revealing the image provided below?", "options": [{"label": "A", "text": "Hydatid cyst", "correct": true}, {"label": "B", "text": "Anthrax", "correct": false}, {"label": "C", "text": "Silicosis", "correct": false}, {"label": "D", "text": "Byssinosis", "correct": false}], "correct_answer": "A. Hydatid cyst", "question_images": ["https://image.prepladder.com/content/QsX3UqY0pCSLCDVvI20V1746696642.png"], "explanation_images": ["https://image.prepladder.com/content/wtV3xXigNHAmWMPr7FV21746696917.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The structure marked with arrowhead is?", "options": [{"label": "A", "text": "Esophagus", "correct": false}, {"label": "B", "text": "Pulmonary artery", "correct": false}, {"label": "C", "text": "Trachea", "correct": true}, {"label": "D", "text": "Left atrium", "correct": false}], "correct_answer": "C. Trachea", "question_images": ["https://image.prepladder.com/content/Os7vUGLNj6Y0FqSUxC4v1748158803.png"], "explanation_images": ["https://image.prepladder.com/content/dti1kV74I1xW2g3ksIdO1748158877.png"], "explanation": "<p>Correct Answer C- Trach\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented with complaints with dyspnoea. The shown X-ray is suggestive of:-", "options": [{"label": "A", "text": "Consolidation", "correct": false}, {"label": "B", "text": "Exudative pleural effusion", "correct": true}, {"label": "C", "text": "Pneumothorax", "correct": false}, {"label": "D", "text": "Hydropneumothorax", "correct": false}], "correct_answer": "B. Exudative pleural effusion", "question_images": ["https://image.prepladder.com/content/Q93SGrxjbKc2t0oh5ZCv1747130576.png"], "explanation_images": ["https://image.prepladder.com/content/E0pngyI3T72gZzyysXXw1747130609.png", "https://image.prepladder.com/content/tR9FKryG1Fi1o15AAxjV1747130622.png", "https://image.prepladder.com/content/krDLNkc7kRmHXz6YkVX61747130644.png", "https://image.prepladder.com/content/gVABRDOtF7MUefAzAPeQ1747130661.png", "https://image.prepladder.com/content/pl9zO3h8mWNP8LTVLfDc1747130672.png", "https://image.prepladder.com/content/57zs9i3TxC1ETDfRXjif1748158954.png", "https://image.prepladder.com/content/2eREL3TgctvL3WKRQVed1747130700.png", "https://image.prepladder.com/content/zGHPri1M30mKtPad0Dxu1747130891.png"], "explanation": "<p>Correct Answer B- Exudative pleural effu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the sign:", "options": [{"label": "A", "text": "Seashore sign", "correct": true}, {"label": "B", "text": "Barcode sign", "correct": false}, {"label": "C", "text": "Stratosphere sign", "correct": false}, {"label": "D", "text": "Deep sulcus sign", "correct": false}], "correct_answer": "A. Seashore sign", "question_images": ["https://image.prepladder.com/content/3090LONxvs5KZm2lfM961747131044.png"], "explanation_images": ["https://image.prepladder.com/content/XP2wBunLq7Bd4fxqomYL1747131095.png", "https://image.prepladder.com/content/utUrx37obg5I1JPnAI7q1747131101.png", "https://image.prepladder.com/content/N3CMgF9Hm69vTG9TYNng1747131105.png", "https://image.prepladder.com/content/n5YJ68W09O2AySvbmmYX1747131118.png"], "explanation": "<p>Correct Answer A- Seashore sig\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male patient presented with a productive cough. He is a chronic smoker and alcoholic. CXR is shown below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Abscess", "correct": false}, {"label": "B", "text": "Consolidation", "correct": true}, {"label": "C", "text": "Cavity", "correct": false}, {"label": "D", "text": "Pleural effusion", "correct": false}], "correct_answer": "B. Consolidation", "question_images": ["https://image.prepladder.com/content/troIeuUibOjAtpyy2sXm1748159148.png"], "explanation_images": ["https://image.prepladder.com/content/DhAWvrD9wJHwTn2jBtLR1747132035.png", "https://image.prepladder.com/content/APhFlGPhBHR9HAltm2Qj1747132063.png"], "explanation": "<p>Correct Answer B- Consolidation</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:686px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>CXR Radiological Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Associated Diseases</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Consolidation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Pneumonia, Lung abscess</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Infiltrates</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Pulmonary edema, ARDS</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Atelectasis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Obstructive lung disease, Pneumothorax</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Blunting of the <span class=\"customMeta\" data-dictid=\"03b5b4a6ef1692777185c8ff0d80d2\">Costophrenic</span> Angle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Pleural effusion, Empyema</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Cavity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Tuberculosis, Lung abscess</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Nodule/mass</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Lung cancer, <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> metastasis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Ground-glass opacities</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Interstitial lung diseases (e.g., <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> fibrosis, Pneumoconiosis)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Honeycombing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Idiopathic <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> fibrosis, End-stage <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> lung disease</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Air bronchograms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Consolidation, Alveolar processes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Mediastinal shift</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Pneumothorax, Large pleural effusion, Mediastinal mass</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented with fever and cough with expectoration. The chest X-ray has been shown below. What is the likely causative organism?", "options": [{"label": "A", "text": "Hemophilus influenza", "correct": false}, {"label": "B", "text": "Parainfluenza virus", "correct": false}, {"label": "C", "text": "Pneumococcus", "correct": true}, {"label": "D", "text": "S.aureus", "correct": false}], "correct_answer": "C. Pneumococcus", "question_images": ["https://image.prepladder.com/content/uOerwM8glmKsTBY4iwXc1748159338.png"], "explanation_images": [], "explanation": "<p>Correct Answer C- Pneumococcus</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Radiological Findings</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Staphylococcal Pneumonia</strong> <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Air Bronchogram</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Mycoplasma Pneumonia</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reticulonodular Markings</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Klebsiella Pneumonia</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bulging Fissure Sign</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Legionella Pneumonia</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bilateral Multifocal Consolidation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pneumocystis carinii Pneumonia</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reticular Shadows and multiple cysts more often in the upper part of the lungs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lung Abscess</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Air-Fluid Level</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Aspergilloma</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Fungal ball/ Monad sign</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Allergic Bronchopulmonary Aspergillosis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Gloved-Finger Sign</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Invasive Aspergillosis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Air-Crescent Sign/ <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">Halo</span> sign</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Adenoid Hypertrophy</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Adenoid Enlargement</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Acute Epiglottitis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Thumb Sign</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Croup (Parainfluenza) (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Steeple Sign</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Mucormycosis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reverse <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> sign/Bird nest sign/Atoll sign</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Haemophilus influenzae (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Patchy or <span class=\"customMeta\" data-dictid=\"6c572343621692777198867cf8d853\">segmental</span> consolidation, may have pleural effusion</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The given USG of lung shows:", "options": [{"label": "A", "text": "Stratosphere sign", "correct": false}, {"label": "B", "text": "Sea shore sign", "correct": true}, {"label": "C", "text": "Troposphere sign", "correct": false}, {"label": "D", "text": "Mirror image artifact", "correct": false}], "correct_answer": "B. Sea shore sign", "question_images": ["https://image.prepladder.com/content/CG4UEDNgNkpbhrpUn0Ez1695369432.png"], "explanation_images": ["https://image.prepladder.com/content/sw3JGwXNCT3uEvV5ImWa1698754040.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:653px\">\n<thead>\n<tr>\n<th scope=\"col\" style=\"vertical-align:bottom\">\n<p><strong>Sign</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:bottom\">\n<p><strong>Description</strong></p>\n</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Stratosphere sign</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Not a recognized sign in lung <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> imaging</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Sea shore sign</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Wavy, <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> border between <span class=\"customMeta\" data-dictid=\"70110a9db41692777180eb90546ee2\">aerated</span> lung and fluid-filled or consolidated lung tissue</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Troposphere sign</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Not a recognized sign in lung <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> imaging</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Mirror image artifact</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Artifact where a structure appears duplicated or mirrored in the <span class=\"customMeta\" data-dictid=\"df077f2c3d16927772019f8223e58f\">ultrasound</span> image, not specific to lung imaging</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old male presents with a history of low-grade fever and cough. Based on the provided Chest X-ray image, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Lung cancer", "correct": false}, {"label": "B", "text": "Miliary TB", "correct": true}, {"label": "C", "text": "ARDS", "correct": false}, {"label": "D", "text": "Aspergilloma", "correct": false}], "correct_answer": "B. Miliary TB", "question_images": ["https://image.prepladder.com/content/fOsjdMjzArUlJ5FjJjCr1747224883.png"], "explanation_images": ["https://image.prepladder.com/content/GQParDOff5QqJv57Ztjd1747380867.png", "https://image.prepladder.com/content/LGF3xk5f65nmZguAZ0Xb1747380878.png", "https://image.prepladder.com/content/dUwTn0aQetGSvHsMtbKn1747380884.png", "https://image.prepladder.com/content/uUdYiO7wxMmpwSWYv0Ex1747380920.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following findings are seen in a high-resolution CT scan of fungal pneumonia? 1. Interlobular septations 2. Peripheral wedge-shaped consolidation 3. Pleural effusion 4. Cavitatory lesions with surrounding ground glass opacities", "options": [{"label": "A", "text": "1,2,4", "correct": true}, {"label": "B", "text": "1,3,4", "correct": false}, {"label": "C", "text": "1,2,3", "correct": false}, {"label": "D", "text": "2,3,4", "correct": false}], "correct_answer": "A. 1,2,4", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ISXBSjwtAggaVGDNxfPP1745246816.jpg", "https://image.prepladder.com/notes/HO83IHpL5IoFmRhje6Gn1745246829.jpg", "https://image.prepladder.com/notes/iZX3XajHMyrrJs20V27Q1745246155.jpg", "https://image.prepladder.com/notes/M2ja8AHLGCbtMeaDooMR1745246144.jpg"], "explanation": "<table cellpadding=\"0\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Allergic Bronchopulmonary <span class=\"customMeta\" data-dictid=\"f20677153f1692777182eb3e84f780\">Aspergillosis</span> (ABPA)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Glover finger\" data-author=\"M. Kalil, A. Fernandes, Aline Cristiane da Silva Curzel, MĂĄrcio Zamuner Cortez, GlĂĄucia Lima\" data-hash=\"10731\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Allergic-bronchopulmonary-aspergillosis-presenting-Kalil-Fernandes/8332df9d3e4acd3389c885330535fac931554267\" data-tags=\"April2025\" height=\"450\" src=\"https://image.prepladder.com/notes/ISXBSjwtAggaVGDNxfPP1745246816.jpg\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p>⢠ABPA is a <strong>hypersensitivity reaction </strong>affecting the major upper <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> airways leading to upper <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> bronchiectasis.</p>\n<p>⢠It is associated with Elevated <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> IgE levels, Positive <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> precipitins for Aspergillus, Respiratory symptoms similar to asthma, Skin <span class=\"customMeta\" data-dictid=\"d4b70f945316927771972d75389cf0\">reactivity</span> to Aspergillus</p>\n<p> </p>\n<p><strong>Radiographic Findings</strong>:</p>\n<p><strong>⢠Non-segmental opacities</strong> primarily in the upper lobes</p>\n<p>⢠Lobar collapse</p>\n<p>⢠Branching thick <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> opacities due to <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> and <span class=\"customMeta\" data-dictid=\"618e9d3b6416927772031d0260310e\">fungus</span> (known as the <strong>\"finger-in-glove sign\"</strong> or \"Y\" shape)</p>\n<p>⢠Occasional <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> cavitation</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Aspergillus Mycetomas/ Aspergilloma/ Fungal Ball</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"air crescent xray\" data-author=\"Marshall, Geoffrey &amp; Farnquist, Brenda &amp; MacGregor, John &amp; Burrowes, Paul.\" data-hash=\"10732\" data-license=\"OPEN ACCESS\" data-source=\"https://www.researchgate.net/figure/Air-crescent-sign-Frontal-radiograph-A-of-the-chest-shows-cavitating-lesion-within-the_fig1_7240786\" data-tags=\"April2025\" height=\"391\" src=\"https://image.prepladder.com/notes/HO83IHpL5IoFmRhje6Gn1745246829.jpg\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Air crescent\" data-author=\"Kochukunju Raju, Shine &amp; Ghosh, Subha &amp; Mehta, Atul.\" data-hash=\"10726\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/Air-crescent-sign-in-a-patient-with-invasive-aspergillosis_fig17_313820333\" data-tags=\"April2025\" height=\"315\" src=\"https://image.prepladder.com/notes/iZX3XajHMyrrJs20V27Q1745246155.jpg\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<p>⢠Aspergillus mycetomas are <span class=\"customMeta\" data-dictid=\"626a8495ab169277719806e670a934\">saprophytic</span> growths that inhabit<strong> preexisting lung cavities</strong>, </p>\n<p>⢠These are predominantly found in the<strong> upper lobes</strong> and <strong>superior segments </strong>of the <strong>lower lobes</strong>.</p>\n<p> </p>\n<p><strong>CT Characteristics</strong>:</p>\n<p>⢠Appears as a mass with soft-tissue <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> within a lung cavity.</p>\n<p>⢠The mass is usually separated from the <span class=\"customMeta\" data-dictid=\"ddba4206eb169277718335596e86da\">cavity</span> wall by an airspace, known as the <strong>\"Air crescent\" or Monod sign</strong>.</p>\n<p>⢠The position of the mass may change between <span class=\"customMeta\" data-dictid=\"607476ab371692777196d0cb2f13bc\">prone</span> and <span class=\"customMeta\" data-dictid=\"b0976ea1fd16927771995d5c700a21\">supine</span> orientations, demonstrating its mobility.</p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<p><strong>Angioinvasive Aspergillosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Halo sign\" data-author=\"Gaillard F, Bell D, Weerakkody Y, et al. Halo sign (chest). Reference article, Radiopaedia.org (Accessed on 05 Nov 2024) https://doi.org/10.53347/rID-8702\" data-hash=\"10724\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/halo-sign-chest-3\" data-tags=\"April2025\" height=\"391\" src=\"https://image.prepladder.com/notes/M2ja8AHLGCbtMeaDooMR1745246144.jpg\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<p>⢠Primarily occurs in<strong> immunocompromised</strong> individuals, </p>\n<p>⌠Involves invasion and <span class=\"customMeta\" data-dictid=\"43c30dc8c8169277718317ffb7dea0\">blockage</span> of small to medium <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> arteries.</p>\n<p>⌠Leads to the formation of<strong> necrotic hemorrhagic nodules</strong> or infarcts.</p>\n<p> </p>\n<p><strong>CT Findings</strong>:</p>\n<p>⢠Commonly presented as multiple nodules surrounded by a <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> of <span class=\"customMeta\" data-dictid=\"c70bf4cd73169277718868a5f3904b\">ground-glass</span> attenuation<strong> \"halo sign\" </strong>or pleural-based wedge-shaped consolidations. </p>\n<p>⢠The<strong> bronchial cut-off sign</strong> indicates<strong> central necrosis</strong>.</p>\n<p>⢠Nodular opacities tend to be widespread across several lung lobes, unlike the clustered <span class=\"customMeta\" data-dictid=\"d54aac1d5516927771958b92a04d85\">peribronchial</span> opacities seen in bacterial infections.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pulmonary oedema", "correct": true}, {"label": "B", "text": "Hydrothorax", "correct": false}, {"label": "C", "text": "Pleural effusion", "correct": false}, {"label": "D", "text": "Pulmonary fibrosis", "correct": false}], "correct_answer": "A. Pulmonary oedema", "question_images": ["https://image.prepladder.com/content/jC7m9GoC35vYWYGaGp1B1741088166.png"], "explanation_images": ["https://image.prepladder.com/content/l1qCE3cPb5oBdKZR1Ook1741088285.png", "https://image.prepladder.com/content/PAXM9NlkheiMDtBRIa7X1741088581.png", "https://image.prepladder.com/content/9bpwzviQXnkHsQpNQUr51741088224.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardiogenic <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> Edema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Cardiogenic <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> Edema</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Left heart failure, volume overload</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ARDS, infections, sepsis, toxins</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-ray Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A-A</strong>lveolar oedema (Bat wings)</p>\n<p><strong>B-</strong>Kerley <strong>B</strong> lines</p>\n<p><strong>C-C</strong>ardiomegaly</p>\n<p><strong>D-D</strong>ilated Upper <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> vessels</p>\n<p><strong>E</strong>-Pleural <strong>E</strong>ffusion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diffuse alveolar infiltrates, normal heart size</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dyspnea, orthopnea, pink frothy sputum</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe hypoxia, <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> distress</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diuretics, nitrates, and oxygen treat CHF</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oxygen, and <span class=\"customMeta\" data-dictid=\"f14b6fe4d3169277720152885b1b38\">ventilatory</span> support, treat the underlying cause</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 38-year-old patient presents with chest pain and hoarseness of voice for the past month. Based on the radiographic image provided, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Saccular aneurysm of the distal arch", "correct": true}, {"label": "B", "text": "Dissecting aneurysm of the arch of the aorta", "correct": false}, {"label": "C", "text": "Coarctation of the aorta", "correct": false}, {"label": "D", "text": "Stenosis of the aorta", "correct": false}], "correct_answer": "A. Saccular aneurysm of the distal arch", "question_images": ["https://image.prepladder.com/content/ur4UeELho78zNNYQIyeb1724744037.png"], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"df4e8e3ae81692777198a0513bc88c\"&gt;Saccular&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"f2c92eaffe16927771819978aa5666\"&gt;aneurysm&lt;/span&gt; of the &lt;span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\"&gt;distal&lt;/span&gt; arch\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old patient presents with ptosis and muscle weakness that improves with rest. She also complains of dysphagia and has engorged veins in her thorax. Based on the CT scan image provided, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Thymoma", "correct": true}, {"label": "B", "text": "Pancoast tumor", "correct": false}, {"label": "C", "text": "Adenocarcinoma", "correct": false}, {"label": "D", "text": "Small cell lung cancer", "correct": false}], "correct_answer": "A. Thymoma", "question_images": ["https://image.prepladder.com/content/rmESN6H1zuIWTS6E6ZlG1724744195.png"], "explanation_images": [], "explanation": "<p>Correct Option A â Th\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 3-year-old child presents with respiratory distress and a history of recurrent respiratory infections. Based on the radiographs provided, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Lung abscess", "correct": false}, {"label": "B", "text": "Congenital pulmonary airway malformation", "correct": true}, {"label": "C", "text": "Pyopneumothorax", "correct": false}, {"label": "D", "text": "Congenital diaphragmatic hernia", "correct": false}], "correct_answer": "B. Congenital pulmonary airway malformation", "question_images": ["https://image.prepladder.com/content/oYZVptLUe438RHydQ6YF1724748907.png", "https://image.prepladder.com/content/fzUhbAdEuUtw79IVHQBB1724748911.png", "https://image.prepladder.com/content/DC2diBInwzEFe7ruliPW1724748914.png"], "explanation_images": ["https://image.prepladder.com/content/T0QnqJJh796nVY6VT3AY1724749280.png", "https://image.prepladder.com/content/IIL3DIjuyRqaN7tMq8nk1724749294.png"], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\"&gt;Congenital&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\"&gt;pulmonary&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\"&gt;airway&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old patient presented with acute epigastric pain and elevated serum lipase. He was stabilized after three days. What is the most common pathology associated with the chest X-ray obtained?", "options": [{"label": "A", "text": "Acute Respiratory Distress Syndrome (ARDS)", "correct": true}, {"label": "B", "text": "Acute pulmonary edema", "correct": false}, {"label": "C", "text": "Pulmonary thromboembolism", "correct": false}, {"label": "D", "text": "Miliary tuberculosis (TB)", "correct": false}], "correct_answer": "A. Acute Respiratory Distress Syndrome (ARDS)", "question_images": ["https://image.prepladder.com/content/95oa6dPY60zk2NoTBLNY1724752043.png"], "explanation_images": [], "explanation": "<table>\n<thead>\n<tr>\n<th>Condition</th>\n<th>Primary Event</th>\n<th>Lung Complication</th>\n<th>Time of Onset</th>\n<th>Imaging Finding</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>Acute pancreatitis</td>\n<td>Inflammation, <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> release</td>\n<td>ARDS</td>\n<td>Within 24â72 hours</td>\n<td>Bilateral infiltrates (non-cardiogenic)</td>\n</tr>\n<tr>\n<td>Heart failure</td>\n<td>Volume overload</td>\n<td>Pulmonary edema</td>\n<td>Variable</td>\n<td>Bilateral <span class=\"customMeta\" data-dictid=\"b78b1bdf6c1692777195170be3d18f\">perihilar</span> haziness + cardiomegaly</td>\n</tr>\n<tr>\n<td>Pulmonary embolism</td>\n<td>Thrombus in <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> arteries</td>\n<td>Infarcts, pleural-based opacities</td>\n<td>Sudden onset</td>\n<td>Wedge-shaped infarcts on CXR/CT</td>\n</tr>\n<tr>\n<td>Miliary TB</td>\n<td>Disseminated TB infection</td>\n<td>Miliary nodules throughout lung</td>\n<td>Subacute/chronic</td>\n<td>Uniform millet-sized nodules</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with foul-smelling sputum, breathlessness, and fever. Based on the X-ray below, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Lung abscess", "correct": true}, {"label": "B", "text": "Pneumothorax", "correct": false}, {"label": "C", "text": "Pleural effusion", "correct": false}, {"label": "D", "text": "Pericardial effusion", "correct": false}], "correct_answer": "A. Lung abscess", "question_images": ["https://image.prepladder.com/content/Jrfi3lGdzMnHDoIjGDA51724912747.png"], "explanation_images": ["https://image.prepladder.com/content/hZq5fWm0HcAMhW40btmS1724932920.png", "https://image.prepladder.com/content/D1CGGLq8qWYSbQfbnxZk1724932876.png", "https://image.prepladder.com/content/4qA8io3paVEWrnqlHtfu1724932967.png"], "explanation": "<p>Correct Option A - Lung\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient complains of difficulty breathing, and fatigue. On examination, distended neck veins and muffled heart sounds were found. X-ray is shown below. Identify the disease.", "options": [{"label": "A", "text": "Constrictive pericarditis", "correct": true}, {"label": "B", "text": "Bronchial asthma", "correct": false}, {"label": "C", "text": "Acute pericarditis", "correct": false}, {"label": "D", "text": "Atrial myxoma", "correct": false}], "correct_answer": "A. Constrictive pericarditis", "question_images": ["https://image.prepladder.com/notes/8a17uOg4WqZKoEpISBnT1747657250.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Finding</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Elevated JVP with rapid y descent</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reflects <strong>rapid early diastolic filling</strong> of the right <span class=\"customMeta\" data-dictid=\"707de303e516927772011cb80f4028\">ventricle</span> due to pressure gradient.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Fatigue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Caused by the heartâs inability to meet <span class=\"customMeta\" data-dictid=\"f3739d892c1692777184b2e134615c\">circulatory</span> demands.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Rapid, low-volume pulse</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Restricted <span class=\"customMeta\" data-dictid=\"52edf0af4d1692777202dd1a490884\">filling</span> limits stroke volume, weakening the pulse.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Pericardial knock</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A <strong>loud early S3 from the thickened pericardium</strong> during diastolic filling.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Kussmaulâs sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Paradoxical rise in JVP during inspiration.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Hepatomegaly</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Liver <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> due to i<strong>ncreased <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> pressure.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Ascites</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Abdominal fluid accumulation due to <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> congestion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Peripheral oedema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Swelling in the extremities from <strong>fluid retention.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Pulsus paradoxus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A fall in <span class=\"customMeta\" data-dictid=\"cf69f5256416927771991c21f264ae\">systolic</span> BP (10mm Hg) during inspiration, potentially <span class=\"customMeta\" data-dictid=\"8ee21101ac1692777189434bcef126\">impalpable</span> pulse.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Atrial fibrillation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Common due to atrial <span class=\"customMeta\" data-dictid=\"3baac9012a1692777189cb4dc70c04\">hypertrophy</span> and dilation.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Investigation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Purpose/Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Chest X-ray</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Egg in a cup appearance</li>\n<li>Detects <span class=\"customMeta\" data-dictid=\"85bd8b2ec816927771958f9ebe3568\">pericardial</span> calcification, a key <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> clue.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Echocardiography</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Visualises thickened <span class=\"customMeta\" data-dictid=\"56ab21797f16927771954b343891ef\">pericardium</span> and assesses <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> function.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>CT scanning</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Helps in visualising <span class=\"customMeta\" data-dictid=\"85bd8b2ec816927771958f9ebe3568\">pericardial</span> calcification.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Complex echo-Doppler and <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> catheterisation </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Square root wave sign</li>\n<li>Used to <span class=\"customMeta\" data-dictid=\"c9001edbf216927771860f3475b44c\">differentiate</span> <span class=\"customMeta\" data-dictid=\"49386582661692777185faf9eaa8d8\">constrictive</span> <span class=\"customMeta\" data-dictid=\"607e653eef1692777195e56becea2c\">pericarditis</span> from restrictive <span class=\"customMeta\" data-dictid=\"6e6dd7aed216927771831ebdf9703c\">cardiomyopathy</span> when diagnosis is uncertain.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Management Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Purpose/Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Medical Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Diuretics (e.g., loop diuretics, spironolactone)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Helps manage <span class=\"customMeta\" data-dictid=\"466b280a461692777186344883956d\">diastolic heart failure</span> by reducing fluid overload.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Surgical Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pericardiectomy</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Definitive treatment through <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> removal of the diseased pericardium. Significant improvement is possible, but the procedure has high <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> risk and suboptimal outcomes in up to 50% of patients.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following conditions is not a potential cause for the radiological finding shown below?", "options": [{"label": "A", "text": "Consolidation", "correct": false}, {"label": "B", "text": "Collapse", "correct": false}, {"label": "C", "text": "Pleural effusion", "correct": false}, {"label": "D", "text": "Foreign body", "correct": true}], "correct_answer": "D. Foreign body", "question_images": ["https://image.prepladder.com/content/0N9yQ20XekpIGeopUtst1747381033.png"], "explanation_images": ["https://image.prepladder.com/content/G7F7nPaFvUUByvXja6Q81747381044.png", "https://image.prepladder.com/content/LC9qFYMWrKt5u3pL8ybL1747381052.png", "https://image.prepladder.com/content/ZVFhNAmWQ1ymPDbbVPZu1747381071.png", "https://image.prepladder.com/content/aXmTkQz6s6BwI8TGP5bS1747381081.png", "https://image.prepladder.com/content/bYgV7zsnHdRDVm95nL3K1747381091.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:739px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Whiteout hemithorax/Opacified <span class=\"customMeta\" data-dictid=\"b260e236dd169277718828436007c2\">hemithorax</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Blackout hemithorax/Hyperlucent <span class=\"customMeta\" data-dictid=\"b260e236dd169277718828436007c2\">hemithorax</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>This refers to when there is complete <span class=\"customMeta\" data-dictid=\"990cbfd3111692777194c6967ee125\">opacification</span> of an entire hemithorax.</li>\n<li>Clinical information and other radiological findings are important to make a definite diagnosis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>This refers to an entire hyperlucent hemithorax.</li>\n<li>It results from various <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> and <span class=\"customMeta\" data-dictid=\"0f0b2969921692777180de24f0b0c0\">acquired</span> conditions of the <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> parenchyma, airway, <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> vasculature, pleural space, and chest wall.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top; width:338px\">\n<p style=\"text-align:center\"><strong>Differential diagnoses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top; width:401px\">\n<p style=\"text-align:center\"><strong>Differential diagnoses </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Atelectasis of the entire lung</li>\n<li>Large pleural <span class=\"customMeta\" data-dictid=\"73909075e71692777187f08d3c9b7e\">effusion</span> <strong>(Option C)</strong></li>\n<li>Pneumonia of the entire lung</li>\n<li>Postpneumonectomy appearance</li>\n<li>Large pulmonary, pleural, or <span class=\"customMeta\" data-dictid=\"06e0403a9c16927771846fde1c53f8\">chest wall</span> mass in diseases like Ewing sarcoma, mesothelioma</li>\n<li>Pulmonary <span class=\"customMeta\" data-dictid=\"35c595890e1692777189a68438427a\">hypoplasia</span> or agenesis</li>\n<li>Consolidation<strong> (Option A)</strong></li>\n<li>Collapse <strong>(Option B)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Radiologic technique errors</li>\n<li>Emphysema (bullous emphysema)</li>\n<li>Asymmetric <span class=\"customMeta\" data-dictid=\"06e0403a9c16927771846fde1c53f8\">chest wall</span> soft tissue due to conditions like:\n\t\t\t\t<ul>\n<li>Poland syndrome</li>\n<li>Unilateral mastectomy</li>\n<li>Some professions like butchers, carpenters, etc</li>\n</ul>\n</li>\n<li>Atrophy of trapezius muscle after radical neck dissection</li>\n<li>Extrapulmonary air collection in <span class=\"customMeta\" data-dictid=\"d9d1e6f2801692777196f37b28fb6a\">pneumothorax</span> and <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">subcutaneous</span> emphysema</li>\n<li>Contralateral large pleural <span class=\"customMeta\" data-dictid=\"73909075e71692777187f08d3c9b7e\">effusion</span> (Pseudo hyperlucent appearance of opposite lung)</li>\n<li><strong>Bronchial obstruction</strong>\n<ul>\n<li><strong>Foreign body in children</strong></li>\n<li><strong>Bronchial <span class=\"customMeta\" data-dictid=\"5c10d19e4416927771829871a1737f\">atresia</span> </strong></li>\n<li><strong>Endobronchial tumor</strong></li>\n<li><strong>Broncholith </strong></li>\n</ul>\n</li>\n<li>Bronchiolitis obliterans in Swyer-James syndrome</li>\n<li>Congenital <span class=\"customMeta\" data-dictid=\"82ded933641692777191ee421dc094\">lobar</span> hyperinflation</li>\n<li>Conditions affecting <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> vessels:\n\t\t\t\t<ul>\n<li>Pulmonary <span class=\"customMeta\" data-dictid=\"133b86a0a516927771809ea08682e8\">agenesis</span> or hypoplasia</li>\n<li>Proximal <span class=\"customMeta\" data-dictid=\"abc81e8daf1692777190c03d7842ef\">interruption</span> of <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> artery</li>\n<li>Massive central <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"1c07a1135f1692777187f547678386\">embolism</span> (PE) leading to oligemia</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Ghosh, Nilanjan, Nabanita Das and Kaustav Nayek.\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Lung-Hypoplasia-Without-Other-Congenital-Anomaly-A-Ghosh-Das/b0537ecc97ea8c72428edfbed26382538dda28be\" data-tags=\"\" height=\"263\" src=\"https://image.prepladder.com/content/G7F7nPaFvUUByvXja6Q81747381044.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"Shahi, Pratyush, Apoorv Sehgal, Ahmer Zafar, Aarushi Sudan and Vishali Moond. âBrachysyndactyly in Poland Syndrome.â Cureus 12 (2020): n. pag.\" data-source=\"https://www.semanticscholar.org/paper/Brachysyndactyly-in-Poland-Syndrome-Shahi-Sehgal/ee9bbefd60286924117208acfb7630a98df9e7d4\" data-tags=\"\" height=\"500\" src=\"https://image.prepladder.com/content/LC9qFYMWrKt5u3pL8ybL1747381052.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Mathew, Denny, Daniel Nicholas Prince and Nasreen Mahomed. âExtra-skeletal Ewing Sarcoma of the chest wall in a child.â SA Journal of Radiology 23 (2019): n. pag.\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Extra-skeletal-Ewing-Sarcoma-of-the-chest-wall-in-a-Mathew-Prince/812ed8936a518996dcb366c0e7b35a1782308b43\" data-tags=\"\" height=\"412\" src=\"https://image.prepladder.com/content/ZVFhNAmWQ1ymPDbbVPZu1747381071.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Silva, Denise Rossato, Sandra Jungblut Schuh and Paulo de Tarso Roth Dalcin. âPosteroanterior chest X-ray for the diagnosis of pneumothorax: methods, usage, and resolution.â (2010).\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Posteroanterior-chest-X-ray-for-the-diagnosis-of-Silva-Schuh/43977f1ebb88c6bca71a866d47a56d87c704c40a\" data-tags=\"\" height=\"567\" src=\"https://image.prepladder.com/content/aXmTkQz6s6BwI8TGP5bS1747381081.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Agarwal, Ritesh and Ashutosh Nath Aggarwal. âBullous lung disease or bullous emphysema?â Respiratory care 51 5 (2006): 532-4 .\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Bullous-lung-disease-or-bullous-emphysema-Agarwal-Aggarwal/ef2a57a7e08a385b144b258892725b49de5d45aa\" data-tags=\"\" height=\"532\" src=\"https://image.prepladder.com/content/bYgV7zsnHdRDVm95nL3K1747381091.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who has been treated for TB in the past now presented with hemoptysis. Make a diagnosis based on the given X-ray.", "options": [{"label": "A", "text": "Bronchogenic carcinoma", "correct": false}, {"label": "B", "text": "Aspergilloma", "correct": true}, {"label": "C", "text": "Hydatid cyst", "correct": false}, {"label": "D", "text": "Lung abscess", "correct": false}], "correct_answer": "B. Aspergilloma", "question_images": ["https://image.prepladder.com/content/sfufevGw0522pUFxCZrd1747382178.png"], "explanation_images": ["https://image.prepladder.com/content/PbhrhPhLhlDRkzPuFM031747382193.png", "https://image.prepladder.com/content/N2rzjzY78oynORdBTisU1747382219.png", "https://image.prepladder.com/content/mOCUHSdLHCNSc7sR60un1747382240.png", "https://image.prepladder.com/content/nEAVzoBNLrQauJQJYJ7I1747382248.png", "https://image.prepladder.com/content/kFUiAuF9unLnVElsUQnL1747382260.png", "https://image.prepladder.com/content/SITm33uvhR2b5PytMi6I1747382279.png", "https://image.prepladder.com/content/lDmPXlwkWHJ8Fw76EG7g1747382289.png", "https://image.prepladder.com/content/eUNaMaD93022Ygnneetu1747382298.png", "https://image.prepladder.com/content/mMuIQyXoj2LQIEb9Agkk1747382311.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Allergic Bronchopulmonary Aspergillosis (ABPA)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"M. Kalil, A. Fernandes, Aline Cristiane da Silva Curzel, MĂĄrcio Zamuner Cortez, GlĂĄucia Lima\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Allergic-bronchopulmonary-aspergillosis-presenting-Kalil-Fernandes/8332df9d3e4acd3389c885330535fac931554267\" data-tags=\"\" height=\"563\" src=\"https://image.prepladder.com/content/PbhrhPhLhlDRkzPuFM031747382193.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<ul>\n<li>ABPA is a <strong>hypersensitivity reaction </strong>affecting the major upper <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> airways leading to upper <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> bronchiectasis.</li>\n<li>It is associated with Elevated <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> IgE levels, Positive <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> precipitins for Aspergillus, Respiratory symptoms similar to asthma, Skin <span class=\"customMeta\" data-dictid=\"d4b70f945316927771972d75389cf0\">reactivity</span> to Aspergillus</li>\n</ul>\n<p> </p>\n<p><strong>Radiographic Findings</strong>:</p>\n<ul>\n<li><strong>Non-segmental opacities</strong> primarily in the upper lobes</li>\n<li>Lobar collapse</li>\n<li>Branching thick <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> opacities due to <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> and <span class=\"customMeta\" data-dictid=\"618e9d3b6416927772031d0260310e\">fungus</span> (known as the <strong>\"finger-in-glove sign\"</strong> or \"Y\" shape)</li>\n<li>Occasional <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> cavitation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Aspergillus Mycetomas/ Aspergilloma/ Fungal Ball </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Cheo, Seng Wee &amp; Ng, Khai &amp; Low, Qj. (2021). A diabetic lady with difficulty in breathing. Malaysian Family Physician. 16. 126-128. 10.51866/tyk1188. \" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Chest-radiograph-showing-Monods-sign_fig1_356699949\" data-tags=\"\" height=\"287\" src=\"https://image.prepladder.com/content/N2rzjzY78oynORdBTisU1747382219.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<ul>\n<li>Aspergillus mycetomas are <span class=\"customMeta\" data-dictid=\"626a8495ab169277719806e670a934\">saprophytic</span> growths that inhabit<strong> preexisting lung cavities</strong>,</li>\n<li>These are predominantly found in the<strong> upper lobes</strong> and <strong>superior segments </strong>of the <strong>lower lobes</strong>.</li>\n</ul>\n<p> </p>\n<p><strong>CT Characteristics</strong>:</p>\n<ul>\n<li>Appears as a mass with soft-tissue <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> within a lung cavity.</li>\n<li>The mass is usually separated from the <span class=\"customMeta\" data-dictid=\"ddba4206eb169277718335596e86da\">cavity</span> wall by an airspace, known as the <strong>\"Air crescent\" or Monod sign</strong>.</li>\n<li>The position of the mass may change between <span class=\"customMeta\" data-dictid=\"607476ab371692777196d0cb2f13bc\">prone</span> and <span class=\"customMeta\" data-dictid=\"b0976ea1fd16927771995d5c700a21\">supine</span> orientations, demonstrating its mobility.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Angioinvasive Aspergillosis</strong><strong> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Bell D, Weerakkody Y, Al Kabbani A\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/halo-sign-chest-3\" data-tags=\"\" height=\"238\" src=\"https://image.prepladder.com/content/mOCUHSdLHCNSc7sR60un1747382240.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Fig: <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">Halo</span> sign</strong></p>\n<p> </p>\n<ul>\n<li>Primarily occurs in<strong> immunocompromised</strong> individuals,</li>\n<li>Involves invasion and <span class=\"customMeta\" data-dictid=\"43c30dc8c8169277718317ffb7dea0\">blockage</span> of small to medium <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> arteries.</li>\n<li>Leads to the formation of<strong> necrotic hemorrhagic nodules</strong> or infarcts.</li>\n</ul>\n<p> </p>\n<p><strong>CT Findings</strong>:</p>\n<ul>\n<li>Commonly presented as multiple nodules surrounded by a <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> of <span class=\"customMeta\" data-dictid=\"c70bf4cd73169277718868a5f3904b\">ground-glass</span> attenuation<strong> \"halo sign\" </strong>or pleural-based wedge-shaped consolidations. <strong>(Option A)</strong></li>\n<li>The<strong> bronchial cut-off sign</strong> indicates<strong> central necrosis</strong>.</li>\n<li>Nodular opacities tend to be widespread across several lung lobes, unlike the clustered <span class=\"customMeta\" data-dictid=\"d54aac1d5516927771958b92a04d85\">peribronchial</span> opacities seen in bacterial infections.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A child presents with breathlessness. On chest x-ray, the following object is seen. Identify the object.", "options": [{"label": "A", "text": "Button battery", "correct": true}, {"label": "B", "text": "Coin", "correct": false}, {"label": "C", "text": "Ball", "correct": false}, {"label": "D", "text": "Bottle cap", "correct": false}], "correct_answer": "A. Button battery", "question_images": ["https://image.prepladder.com/content/e1hiUqG4xrfAh0TLjxEQ1745930820.png", "https://image.prepladder.com/content/g22tDwjQJQl92TjhCI5w1745930854.png"], "explanation_images": ["https://image.prepladder.com/content/apQprIPTHNdCMlNSS9b31745930978.png", "https://image.prepladder.com/content/4DThKlUc7X5C6z7kkRaF1745930989.png", "https://image.prepladder.com/content/WcECWuYPxgTWxPVc60W61745931010.png", "https://image.prepladder.com/content/33w6iPkl0goQ5YSezKBr1745931037.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Foreign Body</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>AP View</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Lateral View</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Key Feature</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Coin in Esophagus</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"A. G. Naveen Kumar\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/Plain-X-ray-of-neck-and-thorax-AP-and-lateral-view-showing-coin-in-cricopharynx_fig1_328721447\" data-tags=\"\" height=\"3203\" src=\"https://image.prepladder.com/content/apQprIPTHNdCMlNSS9b31745930978.png\" width=\"4167\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Circular opacity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Slit-like appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Common in children, lodges at <span class=\"customMeta\" data-dictid=\"07bb7766221692777185a58cad9233\">cricopharyngeal</span> junction</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Coin in Trachea</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Alan E. Schlesinger,James E. Crowe\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.ajronline.org/doi/10.2214/AJR.10.5386\" data-tags=\"\" height=\"3241\" src=\"https://image.prepladder.com/content/4DThKlUc7X5C6z7kkRaF1745930989.png\" width=\"4167\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Slit-like appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Circular opacity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>High risk of <span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\">airway</span> obstruction</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Button Battery in Esophagus</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Bradley S. Rostad, Edward J. Richer, Erica L. Riedesel, Adina Alazraki\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/An-anteroposterior-chest-radiograph-in-a-1-year-old-boy-with-a-button-battery-in-his_fig1_356690704\" data-tags=\"\" height=\"3956\" src=\"https://image.prepladder.com/content/WcECWuYPxgTWxPVc60W61745931010.png\" width=\"4167\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Brian S. Pugmire, Tom K Lin, Scott Pentiuk, Alessandro de Alarcon, Catherine K Hart, Andrew Trout\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/An-11-month-old-boy-with-button-battery-ingestion-A-lateral-radiograph-of-the-chest_fig3_310783237\" data-tags=\"\" height=\"4167\" src=\"https://image.prepladder.com/content/33w6iPkl0goQ5YSezKBr1745931037.png\" width=\"2669\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Circular <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> with <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Double <span class=\"customMeta\" data-dictid=\"21f826cc7316927771858a31dad57d\">contour</span> ring</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Can cause tissue necrosis, urgent removal needed</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The patient has a history of fever and cough for the last 5 days. The examination findings show crepitations, and a chest X-ray is shown below. Based on these details, what is the likely diagnosis for this patient?", "options": [{"label": "A", "text": "Apical segment of Right lower lobe consolidation", "correct": false}, {"label": "B", "text": "Right middle lobe consolidation", "correct": true}, {"label": "C", "text": "Posterior segment of right lower lobe consolidation", "correct": false}, {"label": "D", "text": "Loculated pleural effusion", "correct": false}], "correct_answer": "B. Right middle lobe consolidation", "question_images": ["https://image.prepladder.com/content/cCPqXpK2Q3xIl8I4Yexj1745317998.png"], "explanation_images": ["https://image.prepladder.com/content/IIvtc9G4OM9RkNqO3f041745318039.png", "https://image.prepladder.com/content/k1pb1oU8bmtBk3kz87Dn1745318039.png", "https://image.prepladder.com/content/YnGj31o0t6FTaj7zwo211745318039.png", "https://image.prepladder.com/content/WO4roO8I2xVF0VCRkGCM1745318039.png", "https://image.prepladder.com/content/cY4gIwtkn0u235mq2wZ41745318039.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please identify the rib that is shown in the X-ray.", "options": [{"label": "A", "text": "3rd rib anterior part", "correct": false}, {"label": "B", "text": "3rd rib posterior part", "correct": true}, {"label": "C", "text": "4th rib anterior part", "correct": false}, {"label": "D", "text": "1st rib anterior part", "correct": false}], "correct_answer": "B. 3rd rib posterior part", "question_images": ["https://image.prepladder.com/notes/YFMDWck97NfVqsoZBYec1747383599.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Hamman sign is seen in", "options": [{"label": "A", "text": "Pneumoperitoneum", "correct": false}, {"label": "B", "text": "Pneumopericardium", "correct": false}, {"label": "C", "text": "Pneumomediastinum", "correct": true}, {"label": "D", "text": "Hydropneumothorax", "correct": false}], "correct_answer": "C. Pneumomediastinum", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/PHdvzNje3Y9wQTt5xfPb1746438089.png", "https://image.prepladder.com/content/GCkOAp3WxfT1JdFF9qvG1746438089.png", "https://image.prepladder.com/content/Iwc4qcadQJuWtUio4eSr1746438089.png", "https://image.prepladder.com/content/gJZATV3220ED560CVdkM1746438298.png", "https://image.prepladder.com/content/bqsGSgKRvo7NTmuse7m91746438343.png", "https://image.prepladder.com/content/mUIUXlfZsMTguNUvPtOH1746438357.png", "https://image.prepladder.com/content/zlFVIY81NLoTfx4X9YJO1746438383.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 47-year-old diabetic patient presents with fever, malaise, and productive cough. Which of the following is an incorrect statement?", "options": [{"label": "A", "text": "Patchy infiltrates are seen in pyogenic pneumonia", "correct": true}, {"label": "B", "text": "Interstitial infiltrates are seen in Mycoplasma pneumonia", "correct": false}, {"label": "C", "text": "Hilar lymphadenopathy with lung infiltrates is seen in malignancy", "correct": false}, {"label": "D", "text": "Aspiration pneumonia is more common in the posterior segment of the upper lobes and superior segment of the lower lobes", "correct": false}], "correct_answer": "A. Patchy infiltrates are seen in pyogenic pneumonia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:684px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Causative Agent</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Specific <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">Imaging</span> Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Streptococcus pneumoniae</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Most common cause of <span class=\"customMeta\" data-dictid=\"d7ccdaffea1692777184e4c19a10aa\">community-acquired</span> <span class=\"customMeta\" data-dictid=\"82ded933641692777191ee421dc094\">lobar</span> <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> in adults.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Staphylococcus aureus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Common in debilitated patients / <span class=\"customMeta\" data-dictid=\"e859b9859716927771991ce3c5e8b1\">superinfection</span> in <span class=\"customMeta\" data-dictid=\"c3817918b816927771902d2176d0c8\">influenza</span> / secondary to IV drug abuse.</li>\n<li>Cavitation common in later radiographs.</li>\n<li>Pneumatoceles (seen in children during recovery phase).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Klebsiella pneumoniae</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Occurs in elderly and alcoholics, usually involves the right upper <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> (RUL).</li>\n<li>Bulging of fissures due to increased involved lung volume.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Legionnaireâs disease (Legionella pneumophila)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Rapidly <span class=\"customMeta\" data-dictid=\"ad56eb6e551692777199ae4ce59798\">spreading</span> <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> from contaminated water sources (ACs, coolers, showers).</li>\n<li>Also presents with diarrhea, mental confusion (hyponatremia), and shock.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Actinomycosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Can <span class=\"customMeta\" data-dictid=\"efaf9e0192169277719278711f7f74\">mimic</span> <span class=\"customMeta\" data-dictid=\"7cabf0723c1692777183971e234185\">bronchogenic</span> carcinoma.</li>\n<li>Soft tissue/bone involvement (periostitis) â key differentiating feature.</li>\n<li>CT: <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">Peripheral</span> <span class=\"customMeta\" data-dictid=\"d9ec45007b1692777189e3b26e44ca\">homogeneous</span> <span class=\"customMeta\" data-dictid=\"b1357efd5116927771859dfba380e7\">consolidation</span> with central low <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> and pleural thickening (diagnostic feature).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Atypical <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (Most common cause: <span class=\"customMeta\" data-dictid=\"28c0a387c916927771930b5215e045\">Mycoplasma</span> pneumoniae)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Atypical organism (lacks cell walls, resistant to penicillins).</li>\n<li>Fine reticular/nodular shadows in <span class=\"customMeta\" data-dictid=\"b78b1bdf6c1692777195170be3d18f\">perihilar</span> region early, which may progress to <span class=\"customMeta\" data-dictid=\"b1357efd5116927771859dfba380e7\">consolidation</span> (rare <span class=\"customMeta\" data-dictid=\"82ded933641692777191ee421dc094\">lobar</span> involvement).</li>\n<li>WBC count usually normal.</li>\n<li>Presents with non-productive cough, absent/minimal sputum.</li>\n<li>Not aspiration-related.</li>\n<li>Common in poorly maintained air-conditioned areas.</li>\n<li>Other <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> causes: <span class=\"customMeta\" data-dictid=\"c3817918b816927771902d2176d0c8\">Influenza</span> A &amp; B, RSV, Adenovirus, <span class=\"customMeta\" data-dictid=\"21e09b6e771692777184f66df5bf7a\">Chlamydia</span> psittaci, <span class=\"customMeta\" data-dictid=\"c9ed7c1a9f1692777185cc193f7ec1\">Coxiella</span> burnetii (Q fever).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Varicella pneumonia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Predominantly <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> opacities (5â10 mm).</li>\n<li>If persistent, may calcify, leading to <span class=\"customMeta\" data-dictid=\"de0ef5a95116927771922f41d2b8b5\">miliary</span> shadows on CXR.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please identify the pathology present in the provided X-ray image.", "options": [{"label": "A", "text": "Pneumothorax", "correct": false}, {"label": "B", "text": "Pneumoperitoneum", "correct": true}, {"label": "C", "text": "Hydrothorax", "correct": false}, {"label": "D", "text": "Normal X-ray", "correct": false}], "correct_answer": "B. Pneumoperitoneum", "question_images": ["https://image.prepladder.com/content/4ulqiVTlkftdLqc3pGsf1688386205.png"], "explanation_images": [], "explanation": "<p>Correct Option B\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Pneumatic Condition</strong></p>\n</td>\n<td>\n<p><strong>X-ray Findings</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pneumothorax</p>\n</td>\n<td>\n<p>- Visible lung collapse with absent lung markings at the periphery</p>\n<p>- Deep <span class=\"customMeta\" data-dictid=\"2a56f52a921692777199df43853eba\">sulcus</span> sign (deep <span class=\"customMeta\" data-dictid=\"03b5b4a6ef1692777185c8ff0d80d2\">costophrenic</span> angle)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pneumoperitoneum</p>\n</td>\n<td>\n<p>- Presence of free air under the diaphragm</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pneumomediastinum</p>\n</td>\n<td>\n<p>- <span class=\"customMeta\" data-dictid=\"17825c11c616927771979bd9b0b285\">Radiolucent</span> streaks outlining the mediastinum</p>\n<p>- Presence of air in the mediastinum</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pneumopericardium</p>\n</td>\n<td>\n<p>- <span class=\"customMeta\" data-dictid=\"17825c11c616927771979bd9b0b285\">Radiolucent</span> outline around the heart</p>\n<p>- Presence of air within the <span class=\"customMeta\" data-dictid=\"85bd8b2ec816927771958f9ebe3568\">pericardial</span> sac</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pulmonary <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">Interstitial</span> Emphysema</p>\n</td>\n<td>\n<p>- <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">Diffuse</span> air-filled lucencies throughout the lung fields</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Subcutaneous Emphysema</p>\n</td>\n<td>\n<p>- Air dissecting through the soft tissues</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pneumocephalus</p>\n</td>\n<td>\n<p>- Air within the <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> cavity</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pneumoperitoneum</p>\n</td>\n<td>\n<p>- Presence of free air under the diaphragm</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pneumatosis Intestinalis</p>\n</td>\n<td>\n<p>- Air within the walls of the intestines</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pneumobilia</p>\n</td>\n<td>\n<p>- Presence of air within the <span class=\"customMeta\" data-dictid=\"7dd6eda7ce169277718325f22de9e8\">biliary</span> system</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is your diagnosis based on the chest X-ray of a patient during the evaluation of PUO?", "options": [{"label": "A", "text": "Miliary tuberculosis", "correct": true}, {"label": "B", "text": "Pulmonary edema", "correct": false}, {"label": "C", "text": "Necrobiotic nodules", "correct": false}, {"label": "D", "text": "Tuberculoma", "correct": false}], "correct_answer": "A. Miliary tuberculosis", "question_images": ["https://image.prepladder.com/content/wimrQZI1OcbIE4A4h6P51687759349.png"], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50-year-old patient has come with sudden onset of chest pain and his CT scan shows the following picture. What is the diagnosis?", "options": [{"label": "A", "text": "Pulmonary embolism", "correct": false}, {"label": "B", "text": "Aortic dissection", "correct": true}, {"label": "C", "text": "Aortic aneurysm", "correct": false}, {"label": "D", "text": "Myocardial infarction", "correct": false}], "correct_answer": "B. Aortic dissection", "question_images": ["https://image.prepladder.com/content/1b3ve38cmROuRq6BXXHQ1691499062.png"], "explanation_images": [], "explanation": "<p>Correct Option B: A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the structure marked in the CT scan shown below:", "options": [{"label": "A", "text": "Descending aorta", "correct": false}, {"label": "B", "text": "Ascending aorta", "correct": false}, {"label": "C", "text": "Superior vena cava", "correct": true}, {"label": "D", "text": "Right pulmonary artery", "correct": false}], "correct_answer": "C. Superior vena cava", "question_images": ["https://image.prepladder.com/content/EQ5ebQdaYhQ1tJTkbgth1691498865.png"], "explanation_images": ["https://image.prepladder.com/content/GoRu427ECadBS2LGyOiN1695368173.png", "https://image.prepladder.com/content/J0t2NOhWZSwuWOkevhwM1695368181.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the diagnosis of an 8-year-old child who has been experiencing a cough for the past 7 months, hemoptysis for 1 month, and fever for 4 days, as shown in the provided X-ray?", "options": [{"label": "A", "text": "Lung abscess", "correct": false}, {"label": "B", "text": "Consolidation", "correct": true}, {"label": "C", "text": "Hydatid cyst", "correct": false}, {"label": "D", "text": "Thoracic duct malformation", "correct": false}], "correct_answer": "B. Consolidation", "question_images": ["https://image.prepladder.com/content/BXN5By03HPVksCTtt7Ob1695369504.png"], "explanation_images": [], "explanation": "<p>Correct Option B.\n<table>\n<thead>\n<tr>\n<td>\n<p><strong>Diagnosis</strong></p>\n</td>\n<td>\n<p><strong>Description</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p>Lung abscess</p>\n</td>\n<td>\n<p>Localized collection of <span class=\"customMeta\" data-dictid=\"e4626b4cea16927771968e59732fef\">pus</span> within the lung parenchyma, often appearing as a <span class=\"customMeta\" data-dictid=\"ddba4206eb169277718335596e86da\">cavity</span> or well-defined round lesion</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Consolidation</p>\n</td>\n<td>\n<p>Solidification of lung tissue due to accumulation of <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> <span class=\"customMeta\" data-dictid=\"2df02c8a091692777187db6df500a1\">exudate</span> or <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">cellular</span> infiltrates within air spaces</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Hydatid cyst</p>\n</td>\n<td>\n<p>Parasitic infection caused by <span class=\"customMeta\" data-dictid=\"dfbc87c3ea1692777186b8daca1935\">Echinococcus</span> granulosus, presenting as a well-defined <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> with daughter cysts</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Thoracic <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> malformation</p>\n</td>\n<td>\n<p>Abnormalities in structure or function of the <span class=\"customMeta\" data-dictid=\"3c6021096816927772007954fcc158\">thoracic</span> duct, responsible for <span class=\"customMeta\" data-dictid=\"4fb6bd90f016927771918d4a2993ed\">lymphatic</span> fluid drainage</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "For the diagnosis of all lung carcinomas, a thorax CECT is necessary. However, in which of the following scenarios is MRI considered beneficial?", "options": [{"label": "A", "text": "Small cell lung carcinoma", "correct": false}, {"label": "B", "text": "Adenocarcinoma", "correct": false}, {"label": "C", "text": "Carcinoid", "correct": false}, {"label": "D", "text": "Pancoast tumor", "correct": true}], "correct_answer": "D. Pancoast tumor", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:653px\">\n<thead>\n<tr>\n<th scope=\"col\" style=\"vertical-align:bottom\">\n<p><strong>Lung <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">Carcinoma</span> Type</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:bottom\">\n<p><strong>Preferred <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">Diagnostic</span> Investigation</strong></p>\n</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Small Cell Lung Carcinoma</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>CECT (Contrast-Enhanced CT) Thorax</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Adenocarcinoma</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>CECT Thorax</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Squamous Cell Carcinoma</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>CECT Thorax</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Large Cell Carcinoma</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>CECT Thorax</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Carcinoid</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>CECT Thorax</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>Pancoast Tumor</p>\n</td>\n<td style=\"border-bottom:1px solid #d9d9e3; border-left:1px solid #d9d9e3; border-right:1px solid #d9d9e3; border-top:1px solid #d9d9e3; vertical-align:bottom\">\n<p>MRI Thorax</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Based on the provided X-ray, identify the likely diagnosis:", "options": [{"label": "A", "text": "Subdiaphragmatic abscess", "correct": false}, {"label": "B", "text": "Pneumothorax", "correct": false}, {"label": "C", "text": "Pneumoperitoneum", "correct": true}, {"label": "D", "text": "Intestinal obstruction", "correct": false}], "correct_answer": "C. Pneumoperitoneum", "question_images": ["https://image.prepladder.com/content/gaX5Jzvr2lb323VjRfCh1698647258.png"], "explanation_images": ["https://image.prepladder.com/content/ViU62ZfZcAZSHSwwSDHF1698647305.png"], "explanation": "<p>Correct Option C.\n<p><strong>Educational Objective:</strong></p>\n<ul><li>⤠Definition and Causes: Understand the definition of pneumoperitoneum and its various causes. Common causes include perforation of a gastrointestinal viscus (such as the stomach or intestines) due to conditions like perforated peptic ulcer, gastrointestinal perforation, or bowel ischemia. Other causes may include postoperative complications, trauma, or medical procedures. Clinical Presentation: Recognize the clinical features of pneumoperitoneum, which may include acute abdominal pain, distention, tenderness, guarding, rebound tenderness, and signs of peritonitis. However, the clinical presentation can vary depending on the underlying cause and the amount of free air present. Diagnostic Imaging: Learn about the role of diagnostic imaging in evaluating pneumoperitoneum. Imaging modalities commonly used include plain abdominal X-rays (supine and upright), CT scans of the abdomen, and sometimes ultrasound. Understand the characteristic findings on imaging, such as air under the diaphragm, the \"free air\" sign, or the Rigler's sign (visualization of both sides of the bowel wall due to air outlining the bowel). Differential Diagnosis: Familiarize yourself with the differential diagnosis of pneumoperitoneum, as other conditions can present with similar symptoms or radiological findings. These may include subdiaphragmatic abscess, pneumomediastinum, pneumothorax, or surgical emphysema. Complications and Management: Understand the potential complications of pneumoperitoneum, such as sepsis, peritonitis, or bowel perforation. Learn about the importance of prompt management, which may involve surgical intervention, medical treatment, or a combination based on the underlying cause and the patient's clinical condition. Follow-up and Prognosis: Gain knowledge about the follow-up and prognosis of patients with pneumoperitoneum, including the importance of monitoring for the resolution of symptoms, infection control, and potential complications.</li><li>⤠Definition and Causes: Understand the definition of pneumoperitoneum and its various causes. Common causes include perforation of a gastrointestinal viscus (such as the stomach or intestines) due to conditions like perforated peptic ulcer, gastrointestinal perforation, or bowel ischemia. Other causes may include postoperative complications, trauma, or medical procedures.</li><li>⤠Clinical Presentation: Recognize the clinical features of pneumoperitoneum, which may include acute abdominal pain, distention, tenderness, guarding, rebound tenderness, and signs of peritonitis. However, the clinical presentation can vary depending on the underlying cause and the amount of free air present.</li><li>⤠Diagnostic Imaging: Learn about the role of diagnostic imaging in evaluating pneumoperitoneum. Imaging modalities commonly used include plain abdominal X-rays (supine and upright), CT scans of the abdomen, and sometimes ultrasound. Understand the characteristic findings on imaging, such as air under the diaphragm, the \"free air\" sign, or the Rigler's sign (visualization of both sides of the bowel wall due to air outlining the bowel).</li><li>⤠Differential Diagnosis: Familiarize yourself with the differential diagnosis of pneumoperitoneum, as other conditions can present with similar symptoms or radiological findings. These may include subdiaphragmatic abscess, pneumomediastinum, pneumothorax, or surgical emphysema.</li><li>⤠Complications and Management: Understand the potential complications of pneumoperitoneum, such as sepsis, peritonitis, or bowel perforation. Learn about the importance of prompt management, which may involve surgical intervention, medical treatment, or a combination based on the underlying cause and the patient's clinical condition.</li><li>⤠Follow-up and Prognosis: Gain knowledge about the follow-up and prognosis of patients with pneumoperitoneum, including the importance of monitoring for the resolution of symptoms, infection control, and potential complications.</li></u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 39-year-old male patient presented with complaints of fever and cough. His chest radiograph shows an air bronchogram sign. The probable diagnosis is :", "options": [{"label": "A", "text": "Pleural effusion", "correct": false}, {"label": "B", "text": "Consolidation", "correct": true}, {"label": "C", "text": "Hilar lymphadenopathy", "correct": false}, {"label": "D", "text": "Bronchiectasis", "correct": false}], "correct_answer": "B. Consolidation", "question_images": [], "explanation_images": [], "explanation": "<table>\n<thead>\n<tr>\n<th><strong>Feature</strong></th>\n<th><strong>Air <span class=\"customMeta\" data-dictid=\"c1edec3f2016927771837727f9d8d0\">Bronchogram</span> Sign</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td><strong>Definition</strong></td>\n<td>Lucent air-filled <span class=\"customMeta\" data-dictid=\"4a371bd76e16927771835d6c738d1d\">bronchi</span> visible against consolidated lung</td>\n</tr>\n<tr>\n<td><strong>Seen in</strong></td>\n<td><strong>Consolidation</strong>, <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> edema, ARDS, some tumors</td>\n</tr>\n<tr>\n<td><strong>Absent in</strong></td>\n<td>Pleural effusion, <span class=\"customMeta\" data-dictid=\"7a5ca69ddf16927771829cd4e4d464\">atelectasis</span> with bronchial obstruction</td>\n</tr>\n<tr>\n<td><strong>Most classical cause</strong></td>\n<td><strong>Lobar <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (consolidation)</strong></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Pick out the diagnosis.", "options": [{"label": "A", "text": "Costochondritis", "correct": false}, {"label": "B", "text": "Spondylolisthesis", "correct": false}, {"label": "C", "text": "Cervical rib", "correct": true}, {"label": "D", "text": "Rib fracture", "correct": false}], "correct_answer": "C. Cervical rib", "question_images": ["https://image.prepladder.com/content/U1g5YA6RbKAbRWzXbxer1691481752.png"], "explanation_images": ["https://image.prepladder.com/content/zOnbs0cyYjfDpxwOJ4Mn1718084785.png", "https://image.prepladder.com/content/4cN9ztotntHrIQ3APNc81718084556.png"], "explanation": "<p>Correct Option C: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The patient presented with dyspnea and the X-ray indicates:", "options": [{"label": "A", "text": "Consolidation", "correct": false}, {"label": "B", "text": "Exudative pleural effusion", "correct": true}, {"label": "C", "text": "Pneumothorax", "correct": false}, {"label": "D", "text": "Hydropneumothorax", "correct": false}], "correct_answer": "B. Exudative pleural effusion", "question_images": ["https://image.prepladder.com/content/wOXHbKujmKK7WBymPrek1695370770.png"], "explanation_images": ["https://image.prepladder.com/content/0JIfRdrbP5xzGnYlesLC1695370786.png", "https://image.prepladder.com/content/cwLE9xz6porPCPanfzTs1695370778.png"], "explanation": "<p>Correct option B\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the structure indicated by the arrowhead in the image provided?", "options": [{"label": "A", "text": "Esophagus", "correct": false}, {"label": "B", "text": "Pulmonary artery", "correct": false}, {"label": "C", "text": "Trachea", "correct": true}, {"label": "D", "text": "Left atrium", "correct": false}], "correct_answer": "C. Trachea", "question_images": ["https://image.prepladder.com/content/SpQjnndwYkZWBkZCm47V1697453745.png"], "explanation_images": ["https://image.prepladder.com/content/nsXzSRN6ugKl3frAGnJQ1697453213.png"], "explanation": "<p>Correct option C\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55 year old male patient presented with complaints of dyspnea with congestive heart failure . The clinician wants to know whether it's HF with preserved EF or reduced EF. Which of the below investigation is used for calculation of ejection fraction ?", "options": [{"label": "A", "text": "MUGA", "correct": true}, {"label": "B", "text": "SPECT using thallium 201", "correct": false}, {"label": "C", "text": "PET myocardial perfusion imaging", "correct": false}, {"label": "D", "text": "Sestamibi scan with pharmacological stress", "correct": false}], "correct_answer": "A. MUGA", "question_images": [], "explanation_images": [], "explanation": "<p>Correct option A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please provide your analysis of the diagnosis based on the CT scan of the chest displayed below.", "options": [{"label": "A", "text": "Aortic dissection", "correct": true}, {"label": "B", "text": "Pulmonary embolism", "correct": false}, {"label": "C", "text": "Cardiac myxoma", "correct": false}, {"label": "D", "text": "Aortic aneurysm", "correct": false}], "correct_answer": "A. Aortic dissection", "question_images": ["https://image.prepladder.com/content/Mie2VzE8egrEiuKFIDgl1691412608.png"], "explanation_images": ["https://image.prepladder.com/content/JBPoERuqnvxW4oGMjkkw1695370599.png", "https://image.prepladder.com/content/g1QUd3CQxiakzkSJpX2K1695370605.png", "https://image.prepladder.com/content/LbQqqeSRvXzIvQqm2cgp1695370583.png", "https://image.prepladder.com/content/SfRgcxWQIUnwsDLUWSPk1695370589.png", "https://image.prepladder.com/content/pdnlLqowcQ846Zkixh9f1695370593.png"], "explanation": "<p>Correct Option A: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient has come in with a combination of fever, cough, and expectoration. The provided image displays the chest X-ray. What is the probable infectious agent responsible for these symptoms?", "options": [{"label": "A", "text": "Hemophilus influenza", "correct": false}, {"label": "B", "text": "Parainfluenza virus", "correct": false}, {"label": "C", "text": "Pneumococcus", "correct": true}, {"label": "D", "text": "S. aureus", "correct": false}], "correct_answer": "C. Pneumococcus", "question_images": ["https://image.prepladder.com/content/VN6Z1Bu2HBEXivK0dBEk1691377895.jpeg"], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Organism</strong></p>\n</td>\n<td>\n<p><strong>Radiological Features</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Streptococcus pneumoniae</p>\n</td>\n<td>\n<p>Lobar consolidation, air bronchograms</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Haemophilus influenzae</p>\n</td>\n<td>\n<p>Patchy or <span class=\"customMeta\" data-dictid=\"6c572343621692777198867cf8d853\">segmental</span> consolidation, may have pleural effusion</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Mycoplasma pneumoniae</p>\n</td>\n<td>\n<p>Interstitial infiltrates, <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> or patchy opacities</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Legionella pneumophila</p>\n</td>\n<td>\n<p>Multilobar involvement, patchy infiltrates</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Staphylococcus aureus</p>\n</td>\n<td>\n<p>Lobar consolidation, cavitation, <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> formation</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Klebsiella pneumoniae</p>\n</td>\n<td>\n<p>Lobar <span class=\"customMeta\" data-dictid=\"b1357efd5116927771859dfba380e7\">consolidation</span> with bulging fissures, <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> formation</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pseudomonas aeruginosa</p>\n</td>\n<td>\n<p>Multilobar involvement, patchy infiltrates, cavitation</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Chlamydophila pneumoniae</p>\n</td>\n<td>\n<p>Interstitial infiltrates, <span class=\"customMeta\" data-dictid=\"c70bf4cd73169277718868a5f3904b\">ground-glass</span> opacities</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Respiratory viruses (e.g., influenza, adenovirus)</p>\n</td>\n<td>\n<p>Diffuse or patchy opacities, may have <span class=\"customMeta\" data-dictid=\"b1357efd5116927771859dfba380e7\">consolidation</span> or <span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\">airway</span> inflammation</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the probable diagnosis for a 35-year-old male patient who has a history of chronic smoking and alcoholism, and is currently experiencing a productive cough? The provided image displays the chest X-ray for reference.", "options": [{"label": "A", "text": "Abscess", "correct": false}, {"label": "B", "text": "Consolidation", "correct": true}, {"label": "C", "text": "Cavity", "correct": false}, {"label": "D", "text": "Pleural effusion", "correct": false}], "correct_answer": "B. Consolidation", "question_images": ["https://image.prepladder.com/content/OBYsRVjpvCiNzxNpFsaz1687413459.png"], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>CXR Radiological Findings</strong></p>\n</td>\n<td>\n<p><strong>Associated Diseases</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Consolidation</p>\n</td>\n<td>\n<p>Pneumonia, Lung abscess</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Infiltrates</p>\n</td>\n<td>\n<p>Pulmonary edema, ARDS</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Atelectasis</p>\n</td>\n<td>\n<p>Obstructive lung disease, Pneumothorax</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pleural effusion</p>\n</td>\n<td>\n<p>Pleural effusion, Empyema</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Cavity</p>\n</td>\n<td>\n<p>Tuberculosis, Lung abscess</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Nodule/mass</p>\n</td>\n<td>\n<p>Lung cancer, <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> metastasis</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Ground-glass opacities</p>\n</td>\n<td>\n<p>Interstitial lung diseases (e.g., <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> fibrosis, Pneumoconiosis)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Honeycombing</p>\n</td>\n<td>\n<p>Idiopathic <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> fibrosis, End-stage <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> lung disease</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Air bronchograms</p>\n</td>\n<td>\n<p>Consolidation, Alveolar processes</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Mediastinal shift</p>\n</td>\n<td>\n<p>Pneumothorax, Large pleural effusion, <span class=\"customMeta\" data-dictid=\"1014e4cf5e169277719246e0ca91df\">Mediastinal</span> mass</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the sign :", "options": [{"label": "A", "text": "Seashore sign", "correct": true}, {"label": "B", "text": "Barcode sign", "correct": false}, {"label": "C", "text": "Stratosphere sign", "correct": false}, {"label": "D", "text": "Deep sulcus sign", "correct": false}], "correct_answer": "A. Seashore sign", "question_images": ["https://image.prepladder.com/content/KuThWDCtbzFzBuhnB4fX1697605886.png"], "explanation_images": ["https://image.prepladder.com/content/8C767Z9hmbDBt0OspXrW1697605687.png", "https://image.prepladder.com/content/4pZVK6Z50dsxe0yoPSDO1697605719.png", "https://image.prepladder.com/content/EX4GWFB77R54aQPPwp911687413173.png", "https://image.prepladder.com/content/bzJtQDEw7AfLDgWRxziT1687413190.png", "https://image.prepladder.com/content/LrGQkzDsxxXkn1lXcBYt1687413210.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the diagnosis of a 74-year-old man, who comes to the outpatient department (OPD) with a history of substantial unintentional weight loss, lack of appetite, and iron deficiency anemia, after a chest x-ray was performed and the results are provided below?", "options": [{"label": "A", "text": "Bronchogenic carcinoma", "correct": false}, {"label": "B", "text": "Mesothelioma", "correct": false}, {"label": "C", "text": "Metastasis", "correct": true}, {"label": "D", "text": "Pneumoconiosis", "correct": false}], "correct_answer": "C. Metastasis", "question_images": ["https://image.prepladder.com/content/TRedbcCp3amcSzGZD9Wg1684992436.png"], "explanation_images": [], "explanation": "<p>Correct Option C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the subject matter of the X-ray image below?", "options": [{"label": "A", "text": "Emphysema", "correct": false}, {"label": "B", "text": "Tension pneumothorax", "correct": false}, {"label": "C", "text": "Pleural effusion", "correct": true}, {"label": "D", "text": "Bronchiectasis", "correct": false}], "correct_answer": "C. Pleural effusion", "question_images": ["https://image.prepladder.com/content/CxPRsvYYf01Jmvf2hg2j1684992686.png"], "explanation_images": ["https://image.prepladder.com/content/CCP8eOXshvlSOFKeyj1A1684992745.png"], "explanation": "<p>Correct Option C\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 63 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question đ§ </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result đ§</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 35-year-old woman presents with B/L hilar lymphadenopathy without any significant lung parenchymal involvement. Her chest X-ray shows symmetric mediastinal and hilar lymphadenopathy in a \"1-2-3\" pattern. What is the most likely stage of sarcoidosis in this patient?", "options": [{"label": "A", "text": "Stage 4", "correct": false}, {"label": "B", "text": "Stage 1", "correct": true}, {"label": "C", "text": "Stage 2", "correct": false}, {"label": "D", "text": "Stage 3", "correct": false}], "correct_answer": "B. Stage 1", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/0EzebdfmF0dJtrMuUcg91744313055.png", "https://image.prepladder.com/notes/sDnwFG5jIb6bVRWArxwg1744313164.png", "https://image.prepladder.com/notes/BJbgPozmg1vAdE63SYXP1744313322.png", "https://image.prepladder.com/notes/TES4Um0TPvzB0RPoMQ2L1744313441.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:557px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Staging of Sarcoidosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stage 0</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No visible abnormalities</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stage 1</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hilar/mediastinal <span class=\"customMeta\" data-dictid=\"344bcb4e391692777191307c1e0074\">lymphadenopathy</span> without lung parenchymal changes<strong> </strong><strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stage 2</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hilar/mediastinal <span class=\"customMeta\" data-dictid=\"344bcb4e391692777191307c1e0074\">lymphadenopathy</span> with lung disease<strong> (Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stage 3</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diffuse lung disease without lymphadenopathy<strong> (Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stage 4</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>End-stage <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> <strong> (Option A)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male presents with fever, cough, and pleuritic chest pain. X-ray chest is performed, revealing an air bronchogram. Which of the following conditions is characterized by the absence of air bronchograms?", "options": [{"label": "A", "text": "Pleural effusion", "correct": true}, {"label": "B", "text": "Pulmonary consolidation", "correct": false}, {"label": "C", "text": "Adenocarcinoma of the lung", "correct": false}, {"label": "D", "text": "Severe interstitial lung disease", "correct": false}], "correct_answer": "A. Pleural effusion", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/vOIO7JC2kq4CyDl7JTzQ1744361502.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male presents with a chronic cough and mild chest discomfort. A chest X-ray reveals a mediastinal mass with well-defined margins and a paravertebral location, suggestive of a lesion arising from neural tissue. To confirm the diagnosis and further evaluate the mass, the physician orders additional imaging. What is the most appropriate imaging modality to confirm the diagnosis?", "options": [{"label": "A", "text": "MRI of the chest", "correct": true}, {"label": "B", "text": "PET-CT scan", "correct": false}, {"label": "C", "text": "CT scan of the chest with contrast", "correct": false}, {"label": "D", "text": "Ultrasound", "correct": false}], "correct_answer": "A. MRI of the chest", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zkajpQAjXAeEDjVuma4P1744259987.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:695px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Compartment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Boundaries</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Common Masses/Abnormalities</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anterior (Prevascular)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Posterior <span class=\"customMeta\" data-dictid=\"a5428882a916927771992a8a0335bf\">sternum</span> to <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> heart and great vessels</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Thymic masses: </strong>Thymoma, <span class=\"customMeta\" data-dictid=\"2221edbfce16927772007d62c44d48\">thymic</span> hyperplasia, <span class=\"customMeta\" data-dictid=\"2221edbfce16927772007d62c44d48\">thymic</span> carcinoma</li>\n<li><strong>Germ cell tumors: </strong>Teratoma</li>\n<li><strong>Thyroid masses:</strong> <span class=\"customMeta\" data-dictid=\"0decefe0901692777186f7f3f89b2a\">Ectopic</span> thyroid, <span class=\"customMeta\" data-dictid=\"dd49748d381692777199ce320925d6\">substernal</span> goiter</li>\n<li><strong>Lymphoma: </strong>Hodgkin's, non-Hodgkin's</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Middle (Visceral)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Between <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> compartments</p>\n<p>Contains heart, great vessels, trachea, esophagus, <span class=\"customMeta\" data-dictid=\"4df97a6cbf169277719172fd1af767\">lymph</span> nodes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bronchogenic cysts</li>\n<li>Pericardial cysts</li>\n<li>Lymphadenopathy (metastasis, lymphoma, sarcoidosis)</li>\n<li>Aortic aneurysms, <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> abnormalities</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posterior (Paravertebral)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Posterior heart and <span class=\"customMeta\" data-dictid=\"fa1831d5c016927771886f0447bc65\">great vessels</span> to <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> vertebrae</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Neurogenic tumors: </strong>Schwannomas, neurofibromas, ganglioneuromas</li>\n<li><strong>Esophageal lesions:</strong> Tumors, diverticula</li>\n<li><strong>Spinal abnormalities</strong>: Vertebral infections, hernias, masses</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male presents with drooping of the right eyelid, a constricted right pupil, and lack of sweating on the right side of his face. He also reports weakness, pain, and numbness in his right arm. Chest x-ray reports an apical lung mass on the right side. What is the imaging modality of choice to identify the underlying cause of his symptoms?", "options": [{"label": "A", "text": "Chest X-ray", "correct": false}, {"label": "B", "text": "MRI", "correct": true}, {"label": "C", "text": "CT Scan", "correct": false}, {"label": "D", "text": "PET Scan", "correct": false}], "correct_answer": "B. MRI", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/5kN1zSKkQQqXc61p29xd1744302719.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old man with a history of working as a shipyard worker presents with progressive dyspnea, a persistent dry cough, and chest tightness. He also reports recent weight loss and has experienced crackles upon auscultation. A CT scan of the chest reveals a distinct structure. What could be the underlying mechanism responsible for the observed sign on the CT image?", "options": [{"label": "A", "text": "Round atelectasis causing a distinct pattern of lung collapse.", "correct": true}, {"label": "B", "text": "Calcified pleural plaques resulting in alterations in the pleural surface.", "correct": false}, {"label": "C", "text": "A large nodule surrounded by small nodules indicating a significant inflammatory process.", "correct": false}, {"label": "D", "text": "Interstitial fibrosis leading to a reticular pattern affecting lung architecture.", "correct": false}], "correct_answer": "A. Round atelectasis causing a distinct pattern of lung collapse.", "question_images": ["https://image.prepladder.com/notes/IFyMcOjq3QdnG53y9qRa1744308816.png"], "explanation_images": ["https://image.prepladder.com/notes/PwbVLSNQWQ4t6Kot5HDV1744305873.png", "https://image.prepladder.com/notes/ZChr0TxcBTbUgvuB97Lp1746184842.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:766px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Sign/Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pleural Plaques</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Holly Leaf Sign:</strong> Calcified pleural plaques, exhibiting irregular, thickened <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> edges that resemble the shape of a holly leaf.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA389\" data-author=\"Bickle I, Al Kabbani A, Tatco V\" data-hash=\"8823\" data-license=\"\" data-source=\"https://radiopaedia.org/articles/holly-leaf-sign\" data-tags=\"April2025\" height=\"403\" src=\"https://image.prepladder.com/notes/PwbVLSNQWQ4t6Kot5HDV1744305873.png\" width=\"386\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mesothelioma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiological Feature: </strong>Irregular thickening of the pleura, often involving the <span class=\"customMeta\" data-dictid=\"1014e4cf5e169277719246e0ca91df\">mediastinal</span> pleura, leading to fibrothorax/ frozen.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Comet Tail Sign (Crow's <span class=\"customMeta\" data-dictid=\"32656dc8ba1692777202fc49f9ed13\">Feet</span> Sign)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism:</strong> Localized <span class=\"customMeta\" data-dictid=\"7a5ca69ddf16927771829cd4e4d464\">atelectasis</span> with adjacent blood vessels and <span class=\"customMeta\" data-dictid=\"4a371bd76e16927771835d6c738d1d\">bronchi</span> drawn towards the collapsed area.</p>\n<p><strong>Appearance:</strong> Rounded <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> with curving vessels or <span class=\"customMeta\" data-dictid=\"4a371bd76e16927771835d6c738d1d\">bronchi</span> radiating from it, resembling a cometâs tail or crowâs feet, visible on CT.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Comet Tail Sign\" data-author=\"Campos A, Rock P, Skalina T\" data-hash=\"11549\" data-license=\"\" data-source=\"https://radiopaedia.org/articles/comet-tail-sign-chest-2?lang=us\" data-tags=\"May2025\" height=\"392\" src=\"https://image.prepladder.com/notes/ZChr0TxcBTbUgvuB97Lp1746184842.png\" width=\"384\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male presents with progressive dyspnea, a dry cough, and weight loss over the past six months. On examination, clubbing of the fingers is noted. A chest CT scan reveals a predominantly subpleural reticular pattern with areas of honeycombing predominantly affecting the lower lobes. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Non-Specific Interstitial Pneumonia (NSIP)", "correct": false}, {"label": "B", "text": "Usual Interstitial Pneumonia (UIP)", "correct": true}, {"label": "C", "text": "Cryptogenic Organizing Pneumonia (COP)", "correct": false}, {"label": "D", "text": "Sarcoidosis", "correct": false}], "correct_answer": "B. Usual Interstitial Pneumonia (UIP)", "question_images": ["https://image.prepladder.com/notes/Z8ClncPMFc3l3uxjdies1744314732.png"], "explanation_images": ["https://image.prepladder.com/notes/a7dyr4JpGtu7BqXQQsg51744314923.png", "https://image.prepladder.com/notes/DZhO9JNt8h9tuiFzbxUM1744315032.png", "https://image.prepladder.com/notes/BxglJPCPExL8wSHO46Hi1744315160.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Usual <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">Interstitial</span> <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">Pneumonia</span> (UIP)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Specific <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">Interstitial</span> <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">Pneumonia</span> (NSIP) </strong><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA380\" data-author=\"Yale Rosen from USA \" data-hash=\"8906\" data-license=\"CC BY-SA 2.0\" data-source=\"https://en.wikipedia.org/wiki/Usual_interstitial_pneumonia#/media/File:CT_scan_in_usual_interstitial_pneumonia_(UIP).jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/a7dyr4JpGtu7BqXQQsg51744314923.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA381\" data-author=\"Weerakkody Y, Campos A, Knipe H\" data-hash=\"8909\" data-license=\"\" data-source=\"https://radiopaedia.org/articles/non-specific-interstitial-pneumonia-1\" data-tags=\"April2025\" height=\"577\" src=\"https://image.prepladder.com/notes/DZhO9JNt8h9tuiFzbxUM1744315032.png\" width=\"777\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It presents as a mainly<strong> <span class=\"customMeta\" data-dictid=\"6136118183169277719961922f8790\">subpleural</span> bibasal <span class=\"customMeta\" data-dictid=\"0b6b1f44cb1692777197afef785626\">reticular</span> pattern</strong> with areas of <strong>honeycomb</strong> (subpleural <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> airspaces with discrete, thickened walls that are stacked or lined up in a row) destruction.</li>\n<li>As the disease advances, it tends to spread along the<strong> lung periphery</strong>, affecting the<strong> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> parts</strong> of the <strong>upper lobes</strong>, <span class=\"customMeta\" data-dictid=\"047f8930dd1692777197fed61e213c\">referred</span> to as the <strong>'propeller blade distribution.'</strong></li>\n<li>There are signs of <span class=\"customMeta\" data-dictid=\"66d1f5d3461692777200af5741a710\">traction</span> <span class=\"customMeta\" data-dictid=\"5a31874e311692777183c5a3cc719e\">bronchiectasis</span> and bronchiolectasis.</li>\n<li><strong>Ground-glass opacities</strong> are<strong> not predominant.</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Bilateral <span class=\"customMeta\" data-dictid=\"c70bf4cd73169277718868a5f3904b\">ground-glass</span> opacities</strong> accompanied by fine <strong>reticular patterns</strong>.</li>\n<li>Primarily<strong> peripheral</strong> in<strong> distribution</strong>, but may also appear patchy or band-like.</li>\n<li>Minimal or<strong> absent honeycomb</strong> pattern.</li>\n<li>Presence of <span class=\"customMeta\" data-dictid=\"66d1f5d3461692777200af5741a710\">traction</span> <span class=\"customMeta\" data-dictid=\"5a31874e311692777183c5a3cc719e\">bronchiectasis</span> and bronchiolectasis.</li>\n<li>Subpleural sparing is seen.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The most common HRCT finding in a patient with COVID-19 is:", "options": [{"label": "A", "text": "Consolidation", "correct": false}, {"label": "B", "text": "Ground-glass opacities", "correct": true}, {"label": "C", "text": "Honeycombing", "correct": false}, {"label": "D", "text": "Pleural effusion", "correct": false}], "correct_answer": "B. Ground-glass opacities", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/YqFyKHoCOlQOUmxAfHgV1744315859.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Popcorn calcification in lung is seen in:", "options": [{"label": "A", "text": "Angioinvasive aspergillosis", "correct": false}, {"label": "B", "text": "Aspergillus mycetoma", "correct": false}, {"label": "C", "text": "Bacterial pneumonia", "correct": false}, {"label": "D", "text": "Pulmonary hamartoma", "correct": true}], "correct_answer": "D. Pulmonary hamartoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/2qxDEa0CQq4ug5aDDGBH1746183388.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old shepherd presents with chronic cough and occasional hemoptysis. A chest X-ray is shown below. Which of the following radiological signs is most likely represented in this image?", "options": [{"label": "A", "text": "Meniscus sign", "correct": false}, {"label": "B", "text": "Onion peel sign", "correct": false}, {"label": "C", "text": "Water lily sign", "correct": true}, {"label": "D", "text": "Cumbo sign", "correct": false}], "correct_answer": "C. Water lily sign", "question_images": ["https://image.prepladder.com/notes/Zf9A9nMP7Iuz3Rio9soK1746511867.png"], "explanation_images": ["https://image.prepladder.com/notes/NO6Gpms7UDRnh7lYFd8d1744349975.png", "https://image.prepladder.com/notes/W0OWna94knWlZbE1rd0l1744350026.png", "https://image.prepladder.com/notes/brjrHwvtevxuDmbowdqZ1744350088.png", "https://image.prepladder.com/notes/hh5yER4LbluI1Fd4fUum1744350234.png", "https://image.prepladder.com/notes/jzbziVd2FueNBMtxP5dm1744350438.png", "https://image.prepladder.com/notes/hh5yER4LbluI1Fd4fUum1744350234.png", "https://image.prepladder.com/notes/VQsu010ZDZwWEK3rQGjk1744350294.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:800px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Lung <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hydatid <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hydropneumothorax </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Cavity filled with air &amp; fluid</p>\n<p><img alt=\"RA300\" data-author=\"\" data-hash=\"9121\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"190\" src=\"https://image.prepladder.com/notes/jzbziVd2FueNBMtxP5dm1744350438.png\" width=\"260\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Water lily sign (partially fluid-filled <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> with a floating endocyst)</p>\n<p style=\"text-align:center\"><img alt=\"RA369\" data-author=\"\" data-hash=\"9118\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"214\" src=\"https://image.prepladder.com/notes/hh5yER4LbluI1Fd4fUum1744350234.png\" width=\"240\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>An air fluid level in the pleural space</p>\n<p><img alt=\"RA370\" data-author=\"\" data-hash=\"9119\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"235\" src=\"https://image.prepladder.com/notes/VQsu010ZDZwWEK3rQGjk1744350294.png\" width=\"200\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/m5EJXVxSSloK4VzDC0IL1747761024.mp3", "video": ""}, {"text": "A 30-year-old male presents with fever, cough, night sweats, and unintentional weight loss over the past month. X-ray chest is taken and is shown below. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Miliary Tuberculosis", "correct": true}, {"label": "B", "text": "Pulmonary Sarcoidosis", "correct": false}, {"label": "C", "text": "Mycoplasma Pneumonia", "correct": false}, {"label": "D", "text": "Metastatic Lung Disease", "correct": false}], "correct_answer": "A. Miliary Tuberculosis", "question_images": ["https://image.prepladder.com/notes/pfv9q2ztSD6sOsZVuDKX1744350669.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Infections</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Neoplastic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cardiac </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Miscellaneous </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tuberculosis</li>\n<li>Histoplasmosis</li>\n<li>Blastomycosis</li>\n<li>Coccidioidomycosis</li>\n<li>Mycoplasma pneumonia</li>\n<li>Nocardiosis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bronchoalveolar carcinoma</li>\n<li>Carcinoma lung with <span class=\"customMeta\" data-dictid=\"3291840e671692777191144a261bdd\">lymphangitis</span> carcinomatosa</li>\n<li><strong>Metastatic carcinoma</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hemosiderosis </strong>in long standing condition, rheumatic heart disease, <span class=\"customMeta\" data-dictid=\"d93de7238d16927771922b27cb6086\">mitral</span> stenosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sarcoidosis</li>\n<li><strong>Silicosis</strong></li>\n<li>Tropical <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> eosinophilia</li>\n<li>Hypersensitivity pneumonitis</li>\n<li>Drug-induced <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> lung disease (e.g., methotrexate, cyclophosphamide, nitrofurantoin)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old female presents with a persistent cough, night sweats, and weight loss. The chest X-ray is taken and is shown below. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Lung Abscess", "correct": false}, {"label": "B", "text": "Solitary Cavitary Nodule", "correct": false}, {"label": "C", "text": "Invasive Aspergillosis", "correct": false}, {"label": "D", "text": "Active Pulmonary Tuberculosis", "correct": true}], "correct_answer": "D. Active Pulmonary Tuberculosis", "question_images": ["https://image.prepladder.com/notes/YsFaHddG3U3FJzQWQAuu1744351275.png"], "explanation_images": ["https://image.prepladder.com/notes/JwrowTQbX2WVpEA6goGV1744351346.png", "https://image.prepladder.com/notes/1LchhqYkF0Thr1x4notz1744351383.png", "https://image.prepladder.com/notes/HMUSw2zpnLjcTY8hw3m21744351431.png", "https://image.prepladder.com/notes/gsHvnr0ijUVW0AjYO8CD1744351487.png", "https://image.prepladder.com/notes/1Vv0Loxng6epUEWH4iDX1744351527.png", "https://image.prepladder.com/notes/Um2syXlSTWIKPHOMNDOI1744351568.png", "https://image.prepladder.com/notes/tCZnI3SJGxqOHfDCotzr1744353815.png", "https://image.prepladder.com/notes/pswnozFgX1RQhV0YNa371744353863.png", "https://image.prepladder.com/notes/xB6yOcL7hDt8Ezq66wph1744353977.png", "https://image.prepladder.com/notes/5PxB00bqVCiZYwngINnM1744354014.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 62-year-old male with a history of smoking presents to the emergency department with increased shortness of breath and fever. A chest X-ray is performed, as shown below. Which of the following radiological signs is seen in this case?", "options": [{"label": "A", "text": "Luftsichel sign", "correct": false}, {"label": "B", "text": "Flat waist sign", "correct": false}, {"label": "C", "text": "Golden S sign", "correct": true}, {"label": "D", "text": "Superior triangle sign", "correct": false}], "correct_answer": "C. Golden S sign", "question_images": ["https://image.prepladder.com/notes/eBUd7CVh6zL9ZoX0orju1744352577.png"], "explanation_images": ["https://image.prepladder.com/notes/neDujXg25AVNqFy0XeU01744352727.png", "https://image.prepladder.com/notes/0byF1Id8XKRuVwgu8xkq1744352814.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direct Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indirect Signs </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Loss of aeration</li>\n<li>Displacement of fissures (most reliable and earliest sign)</li>\n<li>Crowding of <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> vessels and bronchi</li>\n<li>Hilar <span class=\"customMeta\" data-dictid=\"a1f256489a16927771870ddd296574\">elevation</span> on PA view: Sign of upper <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> collapse</li>\n<li>Hilar depression: Sign of lower <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> collapse</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Compensatory <span class=\"customMeta\" data-dictid=\"301f9a675d16927771892fb39029d3\">hyperinflation</span> in adjacent lobes</li>\n<li>Mediastinal shift</li>\n<li>Vascular reorientation</li>\n<li>Tracheal shift</li>\n<li>Cardiac outline displacement</li>\n<li>Hemidiaphragm elevation</li>\n<li>Juxtaphrenic peak of diaphragm: Indicate upper <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> collapse</li>\n<li>Rib crowding</li>\n<li>Hilar displacement</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following: Disease Radiologic Finding A) Klebsiella Pneumonia 1) Reticular Shadows B) Aspergilloma 2) Air Bronchogram C) Staphylococcal Pneumonia 3) Bulging Fissure Sign D) Acute Epiglottitis 4) Air-Crescent Sign E) Pneumocystis carinii Pneumonia 5) Thumb Sign", "options": [{"label": "A", "text": "A1, B2, C3, D4, E5", "correct": false}, {"label": "B", "text": "A3, B4, C2, D5, E1", "correct": true}, {"label": "C", "text": "A2, B3, C1, D4, E5", "correct": false}, {"label": "D", "text": "A1, B4, C2, D3, E5", "correct": false}], "correct_answer": "B. A3, B4, C2, D5, E1", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/2FysuZeJXwgoNsG83e2c1744354855.png", "https://image.prepladder.com/notes/1zTHcCzAZQgo3UyYSq0V1744355049.png", "https://image.prepladder.com/notes/JBJZvRHfmEHaDb92reNO1744355288.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FsX2j4AC4EyiDLH20ccE1747672079.mp3", "video": ""}, {"text": "A 45-year-old male presents with a cough, dyspnea, and fever. A chest radiograph shows loss of the right heart border. Which lung area is most likely affected?", "options": [{"label": "A", "text": "Right upper lobe", "correct": false}, {"label": "B", "text": "Right middle lobe", "correct": true}, {"label": "C", "text": "Right lower lobe", "correct": false}, {"label": "D", "text": "Left upper lobe", "correct": false}], "correct_answer": "B. Right middle lobe", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A medical student is learning to identify anterior and posterior ribs on a PA chest X-ray. Identify the labeled rib shown below:", "options": [{"label": "A", "text": "5th Anterior rib", "correct": false}, {"label": "B", "text": "5th Posterior rib", "correct": false}, {"label": "C", "text": "6th Anterior rib", "correct": false}, {"label": "D", "text": "6th Posterior rib", "correct": true}], "correct_answer": "D. 6th Posterior rib", "question_images": ["https://image.prepladder.com/notes/6tilMDC3q9DqnzjnEQMF1746166364.png"], "explanation_images": ["https://image.prepladder.com/notes/JxYG5hzippX76N2l3Kuh1749107572.png", "https://image.prepladder.com/notes/nsz4bc78Bhss1Ww5Nuee1746167435.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 10-year-old child is brought to the emergency by her father after she accidentally swallowed a coin while playing. Her chest X-ray reveals the following findings: Identify the location of the foreign body.", "options": [{"label": "A", "text": "At cricopharyngeus in esophagus", "correct": false}, {"label": "B", "text": "Larynx", "correct": false}, {"label": "C", "text": "At aortic arch in esophagus", "correct": false}, {"label": "D", "text": "Trachea", "correct": true}], "correct_answer": "D. Trachea", "question_images": ["https://image.prepladder.com/notes/11k4fnGTGLxPowiyp4pq1746178121.png"], "explanation_images": ["https://image.prepladder.com/notes/UJH7cBIPviTpo21BwpsY1744259159.png", "https://image.prepladder.com/notes/1k4JgHH15dha8QlhfxWs1744259217.png", "https://image.prepladder.com/notes/Sh9eJq1K0t5Dzjv0sgyt1744259420.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:708px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Coin in <span class=\"customMeta\" data-dictid=\"6a729a105a169277718788389dbeab\">esophagus</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Coin in <span class=\"customMeta\" data-dictid=\"9ebd78bd471692777200ede69e8ed1\">trachea</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Detected using a chest X-ray, the following findings may be noted:\n\t\t\t\t<ul>\n<li>The coin is arranged in the <strong>coronal plane </strong>of the esophagus. <strong>(Option A)</strong></li>\n<li>The most common site of <span class=\"customMeta\" data-dictid=\"aff4ed4b661692777189b2ffa86327\">impaction</span> is at the level of the <strong>cricopharyngeus muscle</strong>.</li>\n<li>Appears round on the <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">frontal</span> (posteroanterior) view.</li>\n<li>It appears tangentially in the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> view.</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chest <span class=\"customMeta\" data-dictid=\"fd0c8ab494169277720227102dc79a\">x-ray</span> findings:\n\t\t\t\t<ul>\n<li>The coin is <strong>arranged in a <span class=\"customMeta\" data-dictid=\"862a709fba1692777198c35e274398\">sagittal</span> plane.</strong></li>\n<li>It appears tangentially in a frontal/PA view.</li>\n<li>Appears <span class=\"customMeta\" data-dictid=\"fc695a78ad16927771878f69871998\">en</span> face in <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> radiographs.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA328\" data-author=\"Louie, Marisa C and Stuart A. Bradin. âForeign body ingestion and aspiration.â Pediatrics in review 30 8 (2009): 295-301, quiz 301 .\" data-hash=\"8380\" data-license=\"\" data-source=\"https://www.semanticscholar.org/paper/Foreign-body-ingestion-and-aspiration.-Louie-Bradin/2753564fd06e31c00ebf44e8005b294701795974\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/UJH7cBIPviTpo21BwpsY1744259159.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA329\" data-author=\"Alan E. Schlesinger,James E. Crowe\" data-hash=\"8381\" data-license=\"\" data-source=\"https://www.ajronline.org/doi/10.2214/AJR.10.5386\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/1k4JgHH15dha8QlhfxWs1744259217.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old woman presents with a chronic productive cough and recurrent episodes of foul-smelling sputum and hemoptysis. A high-resolution CT (HRCT) of the chest is shown below. Which of the following radiological signs is most characteristic of the condition seen in this image?", "options": [{"label": "A", "text": "Tree-in-bud appearance", "correct": false}, {"label": "B", "text": "Ground-glass opacities", "correct": false}, {"label": "C", "text": "Tram track sign", "correct": true}, {"label": "D", "text": "Air bronchogram", "correct": false}], "correct_answer": "C. Tram track sign", "question_images": ["https://image.prepladder.com/notes/PPD9Hec1OUyMAIQG8JZw1746510718.png"], "explanation_images": ["https://image.prepladder.com/notes/7ZHzfTTngx25ggPSjldG1744321957.png", "https://image.prepladder.com/notes/j5CZe5NMWm7tV4Bn6BYg1744322032.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old female presents with sudden-onset chest pain and difficulty breathing after a recent blunt trauma to the chest. Chest CT is taken and is shown below. Which of the following radiological findings is not typically seen in this case?", "options": [{"label": "A", "text": "Barcode sign", "correct": true}, {"label": "B", "text": "Tubular artery sign", "correct": false}, {"label": "C", "text": "Continuous diaphragm sign", "correct": false}, {"label": "D", "text": "Double bronchial wall sign", "correct": false}], "correct_answer": "A. Barcode sign", "question_images": ["https://image.prepladder.com/notes/6DKUMwNB0aR5BPnow4Qp1744321274.png"], "explanation_images": ["https://image.prepladder.com/notes/RWZ84bHGabpSoEzRUkim1744321329.png", "https://image.prepladder.com/notes/XRCwEJfQdLvyGeFKfSTH1744321372.png", "https://image.prepladder.com/notes/bJWg7aLlyXcSLjeeXvVA1744321417.png", "https://image.prepladder.com/notes/y7cqEdj84L5lgcFQ1vLI1744321465.png", "https://image.prepladder.com/notes/tgPfZ0rvtZV3uFuMiZ7H1744321567.png", "https://image.prepladder.com/notes/ASM0g8t4iP2NuIADx3am1744321608.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 68-year-old male patient presents with cough, fever, and pleuritic chest pain. A contrast CT is taken and shown below. What is the most likely diagnosis for this patient?", "options": [{"label": "A", "text": "Lobar Pneumonia", "correct": false}, {"label": "B", "text": "Empyema", "correct": true}, {"label": "C", "text": "Pleural Effusion", "correct": false}, {"label": "D", "text": "Lung Abscess", "correct": false}], "correct_answer": "B. Empyema", "question_images": ["https://image.prepladder.com/notes/LkWj2glmS01kmjhcbYBo1744319873.png"], "explanation_images": ["https://image.prepladder.com/notes/RMgwj98piHmJ6PFIfT6W1744319936.png", "https://image.prepladder.com/notes/lwkMjSfAujweOVb9saOo1744319994.png", "https://image.prepladder.com/notes/dnuLDNV32xY9bddTT39Y1744321008.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:756px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA308\" data-author=\"Rajdev, Kartikeya &amp; Avula, Akshay &amp; Sharma, Dikshya &amp; Mansour, Wissam &amp; Agarwal, Shivika &amp; Siddiqui, Abdul &amp; Chalhoub, Michel\" data-hash=\"8962\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/CT-scan-of-chest-showing-left-sided-pleural-effusion-CT-Computed-tomography_fig3_323461113\" data-tags=\"April2025\" height=\"294\" src=\"https://image.prepladder.com/notes/RMgwj98piHmJ6PFIfT6W1744319936.png\" width=\"373\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA309\" data-author=\"Marshall, Geoffrey &amp; Farnquist, Brenda &amp; MacGregor, John &amp; Burrowes, Paul\" data-hash=\"8963\" data-license=\"\" data-source=\"https://www.researchgate.net/figure/Split-pleura-sign-Enhanced-CT-of-the-chest-shows-a-low-attenuating-pleural-fluid_fig23_7240786\" data-tags=\"April2025\" height=\"217\" src=\"https://image.prepladder.com/notes/lwkMjSfAujweOVb9saOo1744319994.png\" width=\"337\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 75-year-old male patient with a history of congestive heart failure presents with worsening shortness of breath and pleuritic chest pain. A chest X-ray PA view is taken, which is shown below. Which of the following statements about the finding on the chest X-ray is most accurate?", "options": [{"label": "A", "text": "It is most commonly with effusion occupying the oblique fissure.", "correct": false}, {"label": "B", "text": "It may be mistaken for a lung mass due to its appearance.", "correct": true}, {"label": "C", "text": "It will typically require surgical intervention to resolve.", "correct": false}, {"label": "D", "text": "It is always associated with exudative pleural effusion.", "correct": false}], "correct_answer": "B. It may be mistaken for a lung mass due to its appearance.", "question_images": ["https://image.prepladder.com/notes/MeyiPFTWlGFGQdwFSbC51748943491.jpeg"], "explanation_images": ["https://image.prepladder.com/notes/STBqgryTZcYcm92ameKe1744319629.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male with a history of COPD presents with a 2-week history of increasing shortness of breath and a persistent cough. On examination, decreased breath sounds are noted on the left, and a chest X-ray is taken, which is shown below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Lung abscess", "correct": false}, {"label": "B", "text": "Pneumothorax", "correct": false}, {"label": "C", "text": "Pleural effusion", "correct": true}, {"label": "D", "text": "Hydropneumothorax", "correct": false}], "correct_answer": "C. Pleural effusion", "question_images": ["https://image.prepladder.com/notes/ACuoSywpHeAr3rUloIk01744317926.png"], "explanation_images": ["https://image.prepladder.com/notes/rbfZypMNeBqDwcbq7Y6u1744317997.png", "https://image.prepladder.com/notes/r1bOco3XSdfDcxNLEDyZ1744318044.png", "https://image.prepladder.com/notes/t7n2ov9GKPotHpr6JLnd1744318140.png", "https://image.prepladder.com/notes/fKzEoBkF40cWtlkdpPFi1744318304.png", "https://image.prepladder.com/notes/1GsBdxvYY15IQ4a7P48f1744318342.png", "https://image.prepladder.com/notes/ZQlSZH22MQyEFGjHmn3X1746174215.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with a large tension pneumothorax after experiencing a fall is being examined with ultrasound. Which of the following findings will be present in this patient?", "options": [{"label": "A", "text": "Sliding lung sign", "correct": false}, {"label": "B", "text": "Sea-shore sign", "correct": false}, {"label": "C", "text": "Pleural stripe", "correct": false}, {"label": "D", "text": "A-lines", "correct": true}], "correct_answer": "D. A-lines", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/CFZmFrsGygytDrc3xqb41744317389.png", "https://image.prepladder.com/notes/RQZZprxY2RrXSB3GcxGB1744317429.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ultrasound findings in pneumothorax</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pleural <span class=\"customMeta\" data-dictid=\"46eb4a312d169277719950b549eca4\">stripe</span> </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"91b98150ea169277718629280d911c\">echogenic</span> line known as the <strong>'pleural stripe' </strong>reflects most of the <span class=\"customMeta\" data-dictid=\"54d290087e1692777180c6cc682930\">acoustic</span> energy at the air-pleural <span class=\"customMeta\" data-dictid=\"ec503a687b16927771908fbd6d884c\">interface</span> and is the <strong>normal pleura</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Artefacts </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Vertical <span class=\"customMeta\" data-dictid=\"91b98150ea169277718629280d911c\">echogenic</span> bands called <strong>'comet tails' </strong>are <strong>absent in pneumothorax</strong>.</li>\n<li>'<strong>A lines'</strong> are <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> <span class=\"customMeta\" data-dictid=\"6054db421816927771972b4322bd90\">reverberation</span> artefacts caused by reflection from the <span class=\"customMeta\" data-dictid=\"8067ea0c85169277719561c9591e9d\">pleura</span> in the <strong>presence of pneumothorax.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lung sliding </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is a normal finding seen due to the shimmering of the pleural <span class=\"customMeta\" data-dictid=\"46eb4a312d169277719950b549eca4\">stripe</span> at the pleural surface.</li>\n<li>This sign <strong>disappears </strong>in <strong>pneumothorax</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lung point sign </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Indicates the border between sliding lung and <span class=\"customMeta\" data-dictid=\"d9d1e6f2801692777196f37b28fb6a\">pneumothorax</span> which helps assess size.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barcode/ stratosphere sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>In cases where <strong>lung sliding </strong>is <strong>absent</strong>, M-mode images show <strong>uniform <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> straight lines </strong>known as the stratosphere sign or barcode sign.</li>\n<li>This is <strong>seen in pneumothorax.</strong></li>\n<li>Normal lung shows <strong>Sea-shore sign (Option B).</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA291\" data-author=\"Seif, Dina &amp; Perera, Phillips &amp; Mailhot, Thomas &amp; Riley, David &amp; Mandavia, Diku.\" data-hash=\"8935\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/M-mode-of-normal-lung-versus-pneumothorax_fig41_232976339\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/CFZmFrsGygytDrc3xqb41744317389.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA292\" data-author=\"L. Cattarossi, R. Copetti, Giacomo Brusa, Stefano Pintaldi\" data-hash=\"8936\" data-license=\"\" data-source=\"https://www.semanticscholar.org/paper/Lung-Ultrasound-Diagnostic-Accuracy-in-Neonatal-Cattarossi-Copetti/a89d779a2a8e120c8ccedc84dec33ecfb915d9f3/figure/1\" data-tags=\"April2025\" height=\"352\" src=\"https://image.prepladder.com/notes/RQZZprxY2RrXSB3GcxGB1744317429.png\" width=\"491\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient is brought to the emergency after a fall from a tree. He developed shortness of breath and chest pain, is tachypneic, and has distended neck veins on examination. His chest X-ray shows as follows: Which of the following is the correct finding here?", "options": [{"label": "A", "text": "Ipsilateral deviation of mediastinum", "correct": false}, {"label": "B", "text": "Contralateral depression of hemidiaphragm", "correct": false}, {"label": "C", "text": "Collapsed lung", "correct": true}, {"label": "D", "text": "White-out lung", "correct": false}], "correct_answer": "C. Collapsed lung", "question_images": ["https://image.prepladder.com/notes/eyNgKh1wrBYfs1UmMt4B1744317056.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Tension <span class=\"customMeta\" data-dictid=\"d9d1e6f2801692777196f37b28fb6a\">Pneumothorax</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Significant <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> of the <span class=\"customMeta\" data-dictid=\"be2aea1ed01692777192b46ee482a3\">mediastinum</span> <strong>(vs Option A)</strong></li>\n<li>Collapsed lung</li>\n<li>Depression of <span class=\"customMeta\" data-dictid=\"ca762506461692777190f12b43bb1a\">ipsilateral</span> <span class=\"customMeta\" data-dictid=\"dd7d149ec4169277718822fd0f1841\">hemidiaphragm</span> <strong>(vs Option B)</strong></li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA289\" custommeta\"=\"\" data-author=\"Finlayson, Gordon N., Albert Chiang, Jay B Brodsky and Walter Bradford Cannon. âIntraoperative &lt;span class=\" data-dictid=\"1a5d9f72801692777185eb596f3d64\"/>contralateral tension <span class=\"customMeta\" data-dictid=\"d9d1e6f2801692777196f37b28fb6a\">pneumothorax</span> during pneumonectomy.â Anesthesia and analgesia 106 1 (2008): 58-60, table of contents .\" data-hash=\"8932\" data-license=\"OPEN ACCESS\" data-source=\"https://journals.lww.com/anesthesia-analgesia/fulltext/2008/01000/intraoperative_contralateral_tension_pneumothorax.9.aspx\" data-tags=\"April2025\" height=\"382\" src=\"https://image.prepladder.com/notes/GNIKM49bS7b80ApD8HsL1744317108.png\" width=\"400\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/h8wWcO6HP39SzwGRQWJY1745335303.mp3", "video": ""}, {"text": "A patient presents to the clinic with the following anomalies of chest and hands. He has a history of having these anomalies since childhood but has no other symptoms. His chest X-ray shows a left hyperlucent lobe. Which other condition can show a similar chest X-ray picture?", "options": [{"label": "A", "text": "Atelectasis of the entire lung", "correct": false}, {"label": "B", "text": "Pulmonary agenesis", "correct": false}, {"label": "C", "text": "Bullous emphysema", "correct": true}, {"label": "D", "text": "Large pleural effusion", "correct": false}], "correct_answer": "C. Bullous emphysema", "question_images": ["https://image.prepladder.com/notes/rTuuSc2j8QPccyuusOe01744315984.png"], "explanation_images": ["https://image.prepladder.com/notes/04RFLkD2oII7t6IpsaKg1744316050.png", "https://image.prepladder.com/notes/WIbPEqSpR230qIxrMZt21744316174.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:739px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:2px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Whiteout hemithorax/Opacified <span class=\"customMeta\" data-dictid=\"b260e236dd169277718828436007c2\">hemithorax</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:2px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Blackout hemithorax/Hyperlucent <span class=\"customMeta\" data-dictid=\"b260e236dd169277718828436007c2\">hemithorax</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:2px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Differential diagnoses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:2px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Differential diagnoses </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"9\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:2px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Atelectasis of the entire lung <strong>(Option A)</strong></li>\n<li>Large pleural <span class=\"customMeta\" data-dictid=\"73909075e71692777187f08d3c9b7e\">effusion</span> <strong>(Option D)</strong></li>\n<li>Pneumonia of the entire lung</li>\n<li>Postpneumonectomy appearance</li>\n<li>Large pulmonary, pleural, or <span class=\"customMeta\" data-dictid=\"06e0403a9c16927771846fde1c53f8\">chest wall</span> mass like Ewing sarcoma, mesothelioma</li>\n<li>Pulmonary <span class=\"customMeta\" data-dictid=\"35c595890e1692777189a68438427a\">hypoplasia</span> or <span class=\"customMeta\" data-dictid=\"133b86a0a516927771809ea08682e8\">agenesis</span> <strong>(Option B)</strong></li>\n</ul>\n</td>\n<td rowspan=\"9\" style=\"border-bottom:1px solid #000000; border-left:2px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Radiologic technique errors</li>\n<li><strong>Emphysema (bullous emphysema) </strong></li>\n<li>Asymmetric <span class=\"customMeta\" data-dictid=\"06e0403a9c16927771846fde1c53f8\">chest wall</span> soft tissue due to conditions like:\n\t\t\t\t<ul>\n<li><strong>Poland syndrome</strong></li>\n<li>Unilateral mastectomy</li>\n<li>Some professions like butchers, carpenters, etc</li>\n</ul>\n</li>\n<li>Atrophy of trapezius muscle after radical neck dissection</li>\n<li>Extrapulmonary air collection in <span class=\"customMeta\" data-dictid=\"d9d1e6f2801692777196f37b28fb6a\">pneumothorax</span> and <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">subcutaneous</span> emphysema</li>\n<li>Contralateral large pleural <span class=\"customMeta\" data-dictid=\"73909075e71692777187f08d3c9b7e\">effusion</span> (Pseudo hyperlucent appearance of opposite lung)</li>\n<li>Bronchial obstruction\n\t\t\t\t<ul>\n<li>Foreign body in children</li>\n<li>Bronchial atresia</li>\n<li>Endobronchial tumor</li>\n<li>Broncholith</li>\n</ul>\n</li>\n<li>Bronchiolitis obliterans in Swyer-James syndrome</li>\n<li>Congenital <span class=\"customMeta\" data-dictid=\"82ded933641692777191ee421dc094\">lobar</span> hyperinflation</li>\n<li>Conditions affecting <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> vessels:\n\t\t\t\t<ul>\n<li>Pulmonary <span class=\"customMeta\" data-dictid=\"133b86a0a516927771809ea08682e8\">agenesis</span> or hypoplasia</li>\n<li>Proximal <span class=\"customMeta\" data-dictid=\"abc81e8daf1692777190c03d7842ef\">interruption</span> of <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> artery</li>\n<li>Massive central <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"1c07a1135f1692777187f547678386\">embolism</span> (PE) leading to oligemia</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:2px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><br/>\n\t\t\t </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA279\" data-author=\"Ghosh, Nilanjan, Nabanita Das and Kaustav Nayek.\" data-hash=\"8920\" data-license=\"\" data-source=\"https://www.semanticscholar.org/paper/Lung-Hypoplasia-Without-Other-Congenital-Anomaly-A-Ghosh-Das/b0537ecc97ea8c72428edfbed26382538dda28be\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/04RFLkD2oII7t6IpsaKg1744316050.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:2px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"RA280\" data-author=\"Shahi, Pratyush, Apoorv Sehgal, Ahmer Zafar, Aarushi Sudan and Vishali Moond. âBrachysyndactyly in Poland Syndrome.â Cureus 12 (2020): n. pag.\" data-hash=\"8921\" data-license=\"\" data-source=\"https://www.semanticscholar.org/paper/Brachysyndactyly-in-Poland-Syndrome-Shahi-Sehgal/ee9bbefd60286924117208acfb7630a98df9e7d4\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/WIbPEqSpR230qIxrMZt21744316174.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male presents with significant facial swelling, prominent neck veins, and difficulty breathing. These findings suggest an obstruction in the venous return from the head, neck, and upper limbs. A CT scan is conducted to assess the cause of these symptoms. In the diagram provided below, which of the following structures is most likely obstructed, leading to the clinical presentation observed in this patient?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://image.prepladder.com/notes/QgpO3DbojhiA2Lxk8jh31744315313.png"], "explanation_images": ["https://image.prepladder.com/notes/tJOlJZEUu31WP0dTv6z71744315488.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a lateral chest X-ray, which area should you focus on to identify pathology in the hilar region?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://image.prepladder.com/notes/XRPNR7bhesoHlnoU7LWk1744314833.png"], "explanation_images": ["https://image.prepladder.com/notes/xlIkwGnOrBM4bLJP9Zsr1744314901.png", "https://image.prepladder.com/notes/S3M7CmaKAnMBUPpvXTIZ1744314959.png", "https://image.prepladder.com/notes/ypCC26rkKgpFIjK5B4Ji1744315017.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:691px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Right Lung</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Left Lung</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Three lobes:</strong> Upper, Middle, Lower</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Two lobes: </strong>Upper, Lower</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fissures:</strong></p>\n<p><strong>Horizontal fissure:</strong> Separates the upper and middle lobes.</p>\n<p><strong>Oblique fissure:</strong> Separates the middle from the lower lobe, and also divides the upper from the lower lobe.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fissures:</strong></p>\n<p><strong>Oblique (major) fissure:</strong> Separates the upper from the lower lobe.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Elevated Hemidiaphragm</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Flat Hemidiaphragm</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>One side of the <span class=\"customMeta\" data-dictid=\"5b42867b61169277718692205c2447\">diaphragm</span> appears higher than normal.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The normally dome-shaped <span class=\"customMeta\" data-dictid=\"5b42867b61169277718692205c2447\">diaphragm</span> appears flattened and lower in position.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes:</strong></p>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Subphrenic Abscess:</strong> <span class=\"customMeta\" data-dictid=\"e4626b4cea16927771968e59732fef\">Pus</span> beneath diaphragm.</li>\n<li><strong>Hepatomegaly/Splenomegaly: </strong>Enlarged organs push the <span class=\"customMeta\" data-dictid=\"5b42867b61169277718692205c2447\">diaphragm</span> upward.</li>\n<li><strong>Diaphragmatic Palsy</strong>: <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">Paralysis</span> due to <span class=\"customMeta\" data-dictid=\"80686f198416927771959402f37ba8\">phrenic</span> nerve injury.</li>\n<li><strong>Lung Collapse/Fibrosis</strong>: Loss of lung volume elevates the diaphragm.</li>\n<li><strong>Atelectasis:</strong> Collapsed lung leads to <span class=\"customMeta\" data-dictid=\"5b42867b61169277718692205c2447\">diaphragm</span> elevation.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes:</strong></p>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>COPD: </strong>Hyperinflated lungs cause a flat <span class=\"customMeta\" data-dictid=\"5b42867b61169277718692205c2447\">diaphragm</span> and <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> heart appearance.</li>\n<li><strong>Tension Pneumothorax:</strong> Air pushes the <span class=\"customMeta\" data-dictid=\"5b42867b61169277718692205c2447\">diaphragm</span> downward.</li>\n<li><strong>Emphysema:</strong> Destruction of lung tissue results in <span class=\"customMeta\" data-dictid=\"5b42867b61169277718692205c2447\">diaphragm</span> flattening.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Non-clinical question Match the following chest pathologies and their corresponding imaging modalities. Chest Pathology Imaging Modality of Choice 1. Aortic aneurysm a. MRI 2. Pneumonia b. Ultrasound 3. Pleural Effusion c. CECT 4. Posterior mediastinal mass d. Chest X-ray", "options": [{"label": "A", "text": "1 - c, 2 - d, 3 - b, 4 - a", "correct": true}, {"label": "B", "text": "1 - a, 2 - b, 3 - c, 4 - d", "correct": false}, {"label": "C", "text": "1 - b, 2 - d, 3 - c, 4 - a", "correct": false}, {"label": "D", "text": "1 - d, 2 - c, 3 - b, 4 - a", "correct": false}], "correct_answer": "A. 1 - c, 2 - d, 3 - b, 4 - a", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:544px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chest Pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>I-Imaging <span class=\"customMeta\" data-dictid=\"2333eb40ca16927771925442e26719\">Modality</span> of Choice</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Aortic aneurysm</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>c. CECT</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2. Pneumonia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>d. Chest X-ray</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3. Pleural Effusion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>b. Ultrasound</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4. <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">Posterior</span> <span class=\"customMeta\" data-dictid=\"1014e4cf5e169277719246e0ca91df\">mediastinal</span> mass</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>a. MRI</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old male involved in a road traffic accident was stabilized in the field with needle decompression for severe shortness of breath, decreased breath sounds, and hyper-resonance on the right side of the chest. Upon arrival at the emergency department, he is hemodynamically stable. Which chest X-ray view is most appropriate to confirm the underlying condition?", "options": [{"label": "A", "text": "Inspiration Chest X-ray", "correct": false}, {"label": "B", "text": "Expiration Chest X-ray", "correct": true}, {"label": "C", "text": "Lateral Decubitus Chest X-ray", "correct": false}, {"label": "D", "text": "Oblique Chest X-ray", "correct": false}], "correct_answer": "B. Expiration Chest X-ray", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/djXnwYbSD6JfAzncQcna1744313394.png", "https://image.prepladder.com/notes/hxKGl22dgH64OqAME7V71744313472.png", "https://image.prepladder.com/notes/qlZbgvijhT1ZOamQefsg1744313516.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:560px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parameter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Normal Lung</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pneumothorax</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inspiration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Black</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Black</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Expiration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>White</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Black</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 38 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('review-test').addEventListener('click', () => showResults(currentResultQuestion)); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('theme-toggle').addEventListener('click', toggleTheme); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">